Optimal Cut-Off Points for Two-Step Strategy in Screening of Undiagnosed Diabetes: A Population-Based Study in China

Zhen Ye, Liming Cong, Gangqiang Ding, Min Yu, Xinwei Zhang, Ruying Hu, Jianjun Wu, Le Fang, Hao Wang, Jie Zhang, Qingfang He, Danting Su, Ming Zhao, Lixin Wang, Weiwei Gong, Yuanyuan Xiao, Mingbin Liang and Jin Pan

PLOS ONE, 2014, vol. 9, issue 3, 1-6

Abstract: To identify optimal cut-off points of fasting plasma glucose for two-step strategy in screening of undiagnosed diabetes in Chinese people, data were selected from two cross-sectional studies of Metabolic Syndrome in Zhejiang Province of China, Zhejiang Statistical Yearbook (2010), and published literatures. Two-step strategy was used among 17437 subjects sampled from population to screen undiagnosed diabetes. Effectiveness (proportion of cases identified), costs (including medical and non-medical costs), and efficiency (cost per case identified) of these different two-step screening strategies were evaluated. This study found the sensitivities of all the two-step screening strategies with further Oral Glucose Tolerance Test (OGTT) at different Fasting Plasma Glucose (FPG) cut-off points from 5.0 to 7.0 (mmol/L) ranged from 0.66 to 0.91. For the FPG point of 5.0 mmol/L, 91 percent of undiagnosed cases were identified. The total cost of detecting one undiagnosed diabetes case ranged from 547.1 to 1294.5 CNY/case, and the strategy with FPG at cut-off point of 6.1 (mmol/L) resulted in the least cost. Considering both sensitivity and cost of screening diabetes, FPG cut-off point at 5.4 mmol/L was optimized for the two-step strategy. In conclusion, different optimal cut-off points of FPG for two-step strategy in screening of undiagnosed diabetes should be used for different screening purposes.

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0087690

DOI: 10.1371/journal.pone.0087690

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