Illustrative Case in the Model | Age at Diagnosis, y | Results per True Diabetes Case | Results per Person Eligible for Screening | Cost/QALY ($) | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Lifetime Cumulative Incidence (%) | Life-Yearsa | QALYsb | Lifetime Costs ($)a | Life-Years Gaineda | QALYs Gainedb | ||||||||||||
ESRD | LEA | Blind | Stroke | CHD | Screen & Diagnostic Testing | Diab. Treatment | Diab. Intervention | Diab. Complications | Total | ||||||||
Screen at 35 y | (onset at 30 y) | ||||||||||||||||
W/o screening | 40 | 24.28 | 41.05 | 12.89 | 12.41 | 26.87 | 34.05 | 20.08 | 0 | 794 | 897 | 2,677 | 4,369 | ||||
W/ screening | 35 | 23.53 | 41.03 | 12.96 | 12.50 | 27.01 | 34.16 | 20.13 | 25 | 952 | 1,103 | 2,620 | 4,700 | ||||
Screening effect | -0.75 | -0.02 | 0.07 | 0.09 | 0.14 | 0.12 | 0.05 | 25 | 158 | 206 | -58 | 331 | 0.007 | 0.003 | 126,238 | ||
Screen at 45 y | (onset at 40 y) | ||||||||||||||||
W/o screening | 50 | 14.54 | 28.36 | 9.18 | 14.25 | 31.05 | 26.92 | 17.26 | 0 | 639 | 742 | 1,882 | 3,263 | ||||
W/ screening | 45 | 13.99 | 28.32 | 9.25 | 14.34 | 30.91 | 27.02 | 17.32 | 25 | 800 | 957 | 1,844 | 3,627 | ||||
Screening effect | -0.55 | -0.04 | 0.07 | 0.09 | -0.14 | 0.10 | 0.05 | 25 | 162 | 214 | -38 | 364 | 0.005 | 0.003 | 121,965 | ||
Screen at 55 y | (onset at 50 y) | ||||||||||||||||
W/o screening | 60 | 6.25 | 14.89 | 5.23 | 14.47 | 32.76 | 18.96 | 13.32 | 0 | 633 | 687 | 1,552 | 2,872 | ||||
W/ screening | 55 | 6.02 | 14.96 | 5.31 | 14.65 | 31.61 | 19.14 | 13.43 | 25 | 830 | 966 | 1,529 | 3,351 | ||||
Screening effect | -0.23 | 0.07 | 0.08 | 0.18 | -1.15 | 0.18 | 0.11 | 25 | 197 | 279 | -23 | 479 | 0.012 | 0.008 | 62,934 | ||
Screen at 65 y | (onset at 60 y) | ||||||||||||||||
W/o screening | 70 | 1.74 | 5.91 | 2.47 | 14.83 | 30.95 | 12.33 | 9.40 | 0 | 167 | 185 | 453 | 805 | ||||
W/ screening | 65 | 1.67 | 5.94 | 2.53 | 15.05 | 29.38 | 12.50 | 9.51 | 23 | 239 | 295 | 449 | 1,007 | ||||
Screening effect | -0.07 | 0.03 | 0.06 | 0.22 | -1.57 | 0.16 | 0.11 | 23 | 72 | 110 | -4 | 202 | 0.005 | 0.003 | 59,183 | ||
Screen at 75 y | (onset at 70 y) | ||||||||||||||||
W/o screening | 80 | 0.21 | 1.59 | 0.81 | 14.06 | 25.12 | 7.11 | 5.82 | 0 | 53 | 54 | 175 | 282 | ||||
W/ screening | 75 | 0.20 | 1.59 | 0.84 | 14.32 | 23.05 | 7.26 | 5.94 | 8 | 84 | 107 | 175 | 374 | ||||
Screening effect | -0.01 | 0.00 | 0.03 | 0.26 | -2.07 | 0.15 | 0.11 | 8 | 31 | 53 | 0 | 92 | 0.003 | 0.002 | 48,146 |
aUndiscounted.
bDiscounted at 3%.
Note: Screening effects for cumulative incidence are expressed as percentage points. CHD = Coronary heart disease events; Diab. = Diabetes; ESRD = End-stage renal disease; LEA = Lower-extremity amputation; QALY = Quality-adjusted life year.