Cost-effectiveness of the Da Qing diabetes prevention program: A modelling study

Abstract

Objective The Da Qing Diabetes Prevention program (DQDP) was a randomized lifestyle modification intervention conducted in 1986 for the prevention and control of type 2 diabetes in individuals with impaired glucose tolerance. The current study estimated long-term cost-effectiveness of the program based on the health utilities from the Chinese population. Methods A Markov Monte Carlo model was developed to estimate the impact of the intervention from the healthcare system perspective. The analysis was run over 30-year and lifetime periods and costs were estimated respectively as health management service costs. Baseline characteristics and intervention effects were assessed from the DQDP. Utilities and costs were generated from relevant literature. The outcome measures were program cost per quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio (ICER) of the intervention. Sensitivity analyses and threshold analyses were performed. Results Using a 30-year horizon, the intervention strategy was cost-saving and was associated with better health outcomes (increase of 0.74 QALYs per intervention participant). Using a lifetime horizon, the intervention strategy was cost-saving and was associated with additional 1.44 QALYs. Sensitivity analyses showed that the overall ICER was most strongly influenced by the hazard ratio of cardiovascular disease event. Conclusions The Da Qing lifestyle intervention in a Chinese population with impaired glucose tolerance is likely to translate into substantial economic value. It is cost-saving over a 30-year time and lifetime frame.

Associations between CT pulmonary opacity score on admission and clinical characteristics and outcomes in patients with COVID-19

“…A study demonstrated that age and monocyte–lymphocyte ratio may predict imaging progression on chest CT in COVID-19 patients [ 34 ]. Other studies indicated moderate positive correlations between CT severity score and transferrin, lactate dehydrogenase, troponin, and inflammation-related factors of leucocytes, neutrophils, and IL-2R ( r range 0.45–0.60) [ 17 , 35 ], although we were unable to verify those correlations due to lack of data.…”

“…Other studies applied crude CT scoring systems. For example, Wang et al used 0:0%; 1:1–49%; 2:50–75%; 3: > 75%; range 0–3; global score 0–15 [ 16 ]; Hu et al used 0:0%; 1:1–25%; 2:26–50%; 3:51–75%; 4:76–100%; range 0–4; global score 0–20 [ 17 – 21 ]; Francone et al used 0:0%; 1: < 5%; 2:5–25%; 3:26–50%; 4:51–75%; 5: > 75%; range 0–5; global score 0–25 [ 22 , 23 ]; Zhao et al used 0:0%; 1: < 25%; 2:25–49%; 3:50–74%; 4: ≥ 75%; range 0–4; global score 0–24 [ 24 – 26 ]; Aalinezhad et al used another system (0:0%; 1: < 50%; 2: > 50%; range 0–2; global score 0–40) [ 27 , 28 ]. Similarly, Guillo et al used a scoring system of 0–10%, 11–25%, 26–50%, 51–75% and 76–100% ground-glass opacities and consolidation [ 29 ].…”

“…Second, although this study analyzed the effects of pulmonary opacity scores at admission on disease severity, ICU admission and respiratory failure during the whole study period, we only recorded CT at the time of admission; hence it was impossible to analyze the change in pulmonary opacity scores throughout the study period. Third, due to lack of data, we did not analyze associations between CT pulmonary opacity score and some other characteristics, e.g., transferrin, leucocytes and platelet–lymphocyte ratios, which had been reported to be associated with pulmonary opacity score in the previous studies [ 17 , 35 , 49 ]. For the same reason, we did not analyze the association between CT findings and pulmonary embolism although a previous study has showed a high pulmonary embolism prevalence at CT pulmonary angiography in patients testing positive for COVID-19 [ 50 ].…”

Economic Evaluation of Health Behavior Interventions to Prevent and Manage Type 2 Diabetes Mellitus in Asia: A Systematic Review of Randomized Controlled Trials

“…However, no studies were identified through forward and backward searches. Finally, 11 articles met the selection criteria and were included in the review (see Figure 1 for the PRISMA flow diagram) [ 41 , 42 , 43 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ].…”

“…The included studies were conducted in Bangladesh [ 48 ], China [ 47 , 52 ] including Hong Kong [ 51 ], India [ 41 , 43 , 49 ], Malaysia [ 54 ], Singapore [ 42 , 50 ], and Sri Lanka [ 53 ] with T2DM patients and participants who were at high risk of developing T2DM. Participants included in the studies were aged 5 years and above, and the average sample size of the studies was 920 participants (study samples ranged between 166 and 3539 participants).…”