Systematic Review and Meta-Analysis of Response Rates and Diagnostic Yield of Screening for Type 2 Diabetes and Those at High Risk of Diabetes.
<h4>Background</h4>Screening for type 2 diabetes (T2DM) and individuals at risk of diabetes has been advocated, yet information on the response rate and diagnostic yield of different screening strategies are lacking.<h4>Methods</h4>Studies (from 1998 to March/2015) were ident...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135702&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849721164527566848 |
|---|---|
| author | Kamlesh Khunti Hamidreza Mani Felix Achana Nicola Cooper Laura J Gray Melanie J Davies |
| author_facet | Kamlesh Khunti Hamidreza Mani Felix Achana Nicola Cooper Laura J Gray Melanie J Davies |
| author_sort | Kamlesh Khunti |
| collection | DOAJ |
| description | <h4>Background</h4>Screening for type 2 diabetes (T2DM) and individuals at risk of diabetes has been advocated, yet information on the response rate and diagnostic yield of different screening strategies are lacking.<h4>Methods</h4>Studies (from 1998 to March/2015) were identified through Medline, Embase and the Cochrane library and included if they used oral glucose tolerance test (OGTT) and WHO-1998 diagnostic criteria for screening in a community setting. Studies were one-step strategy if participants were invited directly for OGTT and two, three/four step if participants were screened at one or more levels prior to invitation to OGTT. The response rate and diagnostic yield were pooled using Bayesian random-effect meta-analyses.<h4>Findings</h4>47 studies (422754 participants); 29 one-step, 11 two-step and seven three/four-step were identified. Pooled response rate (95% Credible Interval) for invitation to OGTT was 65.5% (53.7, 75.6), 63.1% (44.0, 76.8), and 85.4% (76.4, 93.3) in one, two and three/four-step studies respectively. T2DM yield was 6.6% (5.3, 7.8), 13.1% (4.3, 30.9) and 27.9% (8.6, 66.3) for one, two and three/four-step strategies respectively. The number needed to invite to the OGTT to detect one case of T2DM was 15, 7.6 and 3.6 in one, two, and three/four-step strategies. In two step strategies, there was no difference between the response or yield rates whether the first step was blood test or risk-score. There was evidence of substantial heterogeneity in rates across study populations but this was not explained by the method of invitation, study location (rural versus urban) and developmental index of the country in which the study was performed.<h4>Conclusions</h4>Irrespective of the invitation method, developmental status of the countries and or rural/urban location, using a multi-step strategy increases the initial response rate to the invitation to screening for diabetes and reduces the number needed to have the final diagnostic test (OGTT in this study) for a definite diagnosis. |
| format | Article |
| id | doaj-art-d830c8153e5c4787bbf983034c21f9f3 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-d830c8153e5c4787bbf983034c21f9f32025-08-20T03:11:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01109e013570210.1371/journal.pone.0135702Systematic Review and Meta-Analysis of Response Rates and Diagnostic Yield of Screening for Type 2 Diabetes and Those at High Risk of Diabetes.Kamlesh KhuntiHamidreza ManiFelix AchanaNicola CooperLaura J GrayMelanie J Davies<h4>Background</h4>Screening for type 2 diabetes (T2DM) and individuals at risk of diabetes has been advocated, yet information on the response rate and diagnostic yield of different screening strategies are lacking.<h4>Methods</h4>Studies (from 1998 to March/2015) were identified through Medline, Embase and the Cochrane library and included if they used oral glucose tolerance test (OGTT) and WHO-1998 diagnostic criteria for screening in a community setting. Studies were one-step strategy if participants were invited directly for OGTT and two, three/four step if participants were screened at one or more levels prior to invitation to OGTT. The response rate and diagnostic yield were pooled using Bayesian random-effect meta-analyses.<h4>Findings</h4>47 studies (422754 participants); 29 one-step, 11 two-step and seven three/four-step were identified. Pooled response rate (95% Credible Interval) for invitation to OGTT was 65.5% (53.7, 75.6), 63.1% (44.0, 76.8), and 85.4% (76.4, 93.3) in one, two and three/four-step studies respectively. T2DM yield was 6.6% (5.3, 7.8), 13.1% (4.3, 30.9) and 27.9% (8.6, 66.3) for one, two and three/four-step strategies respectively. The number needed to invite to the OGTT to detect one case of T2DM was 15, 7.6 and 3.6 in one, two, and three/four-step strategies. In two step strategies, there was no difference between the response or yield rates whether the first step was blood test or risk-score. There was evidence of substantial heterogeneity in rates across study populations but this was not explained by the method of invitation, study location (rural versus urban) and developmental index of the country in which the study was performed.<h4>Conclusions</h4>Irrespective of the invitation method, developmental status of the countries and or rural/urban location, using a multi-step strategy increases the initial response rate to the invitation to screening for diabetes and reduces the number needed to have the final diagnostic test (OGTT in this study) for a definite diagnosis.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135702&type=printable |
| spellingShingle | Kamlesh Khunti Hamidreza Mani Felix Achana Nicola Cooper Laura J Gray Melanie J Davies Systematic Review and Meta-Analysis of Response Rates and Diagnostic Yield of Screening for Type 2 Diabetes and Those at High Risk of Diabetes. PLoS ONE |
| title | Systematic Review and Meta-Analysis of Response Rates and Diagnostic Yield of Screening for Type 2 Diabetes and Those at High Risk of Diabetes. |
| title_full | Systematic Review and Meta-Analysis of Response Rates and Diagnostic Yield of Screening for Type 2 Diabetes and Those at High Risk of Diabetes. |
| title_fullStr | Systematic Review and Meta-Analysis of Response Rates and Diagnostic Yield of Screening for Type 2 Diabetes and Those at High Risk of Diabetes. |
| title_full_unstemmed | Systematic Review and Meta-Analysis of Response Rates and Diagnostic Yield of Screening for Type 2 Diabetes and Those at High Risk of Diabetes. |
| title_short | Systematic Review and Meta-Analysis of Response Rates and Diagnostic Yield of Screening for Type 2 Diabetes and Those at High Risk of Diabetes. |
| title_sort | systematic review and meta analysis of response rates and diagnostic yield of screening for type 2 diabetes and those at high risk of diabetes |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135702&type=printable |
| work_keys_str_mv | AT kamleshkhunti systematicreviewandmetaanalysisofresponseratesanddiagnosticyieldofscreeningfortype2diabetesandthoseathighriskofdiabetes AT hamidrezamani systematicreviewandmetaanalysisofresponseratesanddiagnosticyieldofscreeningfortype2diabetesandthoseathighriskofdiabetes AT felixachana systematicreviewandmetaanalysisofresponseratesanddiagnosticyieldofscreeningfortype2diabetesandthoseathighriskofdiabetes AT nicolacooper systematicreviewandmetaanalysisofresponseratesanddiagnosticyieldofscreeningfortype2diabetesandthoseathighriskofdiabetes AT laurajgray systematicreviewandmetaanalysisofresponseratesanddiagnosticyieldofscreeningfortype2diabetesandthoseathighriskofdiabetes AT melaniejdavies systematicreviewandmetaanalysisofresponseratesanddiagnosticyieldofscreeningfortype2diabetesandthoseathighriskofdiabetes |