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RESEARCH PRODUCT

Clinical applicability and cost-effectiveness of DIABSCORE in screening for type 2 diabetes in primary care

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Aims: To evaluate the applicability and cost-effectiveness of a clinical risk score (DIABSCORE) to screen for type 2 diabetes in primary care patients. Methods: Multicenter cross-sectional study of 10,508 adult no previously diagnosed with diabetes, in 2 Spanish regions (Canary Islands and Valencian Community). The variables comprising DIABSCORE were age, waist to height ratio, family history of diabetes and gestational diabetes. ROC curves were obtained; the diabetes prevalences odds ratios (HbA1c >= 6.5%) between patients exposed and not exposed to DIABSCORE >= 100, and to fasting blood glucose >= 126 mg/dL were calculated. The opinions of both the professionals and the patients concerning DIABSCORE were collected, and a cost-effectiveness analysis was performed. Results: In both regions, the valid cut-off point for diabetes (DIABSCORE = 100), showed an area under the curve >0.80. The prevalences odds ratio of diabetes for DIABSCORE >= 100 was 9.5 (3.7-31.5) in Canarian and 18.3 (8.0-51.1) in Valencian; and for glucose >= 126 mg/dL it was, respectively, 123.0 (58.8-259.2) and 303.1 (162.5-583.8). However, glucose >= 126 mg/dL showed a low sensitivity (below 48% in both communities) as opposed to DIABSCORE >= 100 (above 90% in both regions). Professionals (100%) and patients (75%) satisfaction was greater when using DIABSCORE rather than glucose measurement for diabetes screening. The cost of each case of diabetes identified was lower with DIABSCORE >= 100 (7.6 (sic) in Canarian and 8.3 (sic) in Valencian) than glucose >= 126 mg/dL (10.8 (sic) and 10.5 (sic), respectively). Conclusions: DIABSCORE is an applicable and cost-effective screening method for type 2 diabetes in primary care. (C) 2017 Elsevier B.V. All rights reserved.