@article {Johnson307,
author = {Johnson, Susan L. and Tabaei, Bahman P. and Herman, William H.},
title = {The Efficacy and Cost of Alternative Strategies for Systematic Screening for Type 2 Diabetes in the U.S. Population 45{\textendash}74 Years of Age},
volume = {28},
number = {2},
pages = {307--311},
year = {2005},
doi = {10.2337/diacare.28.2.307},
publisher = {American Diabetes Association},
abstract = {OBJECTIVE{\textemdash}To simulate the outcomes of alternative strategies for screening the U.S. population 45{\textendash}74 years of age for type 2 diabetes. RESEARCH DESIGN AND METHODS{\textemdash}We simulated screening with random plasma glucose (RPG) and cut points of 100, 130, and 160 mg/dl and a multivariate equation including RPG and other variables. Over 15 years, we simulated screening at intervals of 1, 3, and 5 years. All positive screening tests were followed by a diagnostic fasting plasma glucose or an oral glucose tolerance test. Outcomes include the numbers of false-negative, true-positive, and false-positive screening tests and the direct and indirect costs. RESULTS{\textemdash} At year 15, screening every 3 years with an RPG cut point of 100 mg/dl left 0.2 million false negatives, an RPG of 130 mg/dl or the equation left 1.3 million false negatives, and an RPG of 160 mg/dl left 2.8 million false negatives. Over 15 years, the absolute difference between the most sensitive and most specific screening strategy was 4.5 million true positives and 476 million false-positives. Strategies using RPG cut points of 130 mg/dl or the multivariate equation every 3 years identified 17.3 million true positives; however, the equation identified fewer false-positives. The total cost of the most sensitive screening strategy was $42.7 billion and that of the most specific strategy was $6.9 billion. CONCLUSIONS{\textemdash} Screening for type 2 diabetes every 3 years with an RPG cut point of 130 mg/dl or the multivariate equation provides good yield and minimizes false-positive screening tests and costs.},
issn = {0149-5992},
URL = {https://care.diabetesjournals.org/content/28/2/307},
eprint = {https://care.diabetesjournals.org/content/28/2/307.full.pdf},
journal = {Diabetes Care}
}