PMID- 26392298
OWN - NLM
STAT- MEDLINE
DCOM- 20160902
LR  - 20151029
IS  - 1399-5448 (Electronic)
IS  - 1399-543X (Linking)
VI  - 16
IP  - 8
DP  - 2015 Dec
TI  - Screening for T1D risk to reduce DKA is not economically viable.
PG  - 565-72
LID - 10.1111/pedi.12313 [doi]
AB  - BACKGROUND: Children at high risk for developing type 1 diabetes (T1D) can be 
      identified on the basis of human leukocyte antigen (HLA) genotype and the 
      subsequent development of islet cell autoantibodies. Several studies have 
      documented reduced incidence of diabetic ketoacidosis (DKA) in new-onset T1D when 
      high-risk children are identified at an early age. Many have questioned whether 
      general population screening for T1D risk should be standard of practice. We 
      sought to perform a purely economic, cost-benefit analysis to determine if a 
      screening program to reduce the incidence of DKA at diagnosis in children less 
      than 5 yr is cost effective. METHODS: We compared the cost of population 
      screening with the benefit of preventing DKA. The cost of screening included 
      one-time HLA typing on the entire population followed by islet cell autoantibody 
      testing in high-risk children every 6 months until age 5 yr. The potential 
      benefits of screening included reductions in parental lost income, medical 
      expenses, morbidity, and mortality. RESULTS: Screening for T1D risk for the sole 
      purpose of reducing the cost of DKA at onset of T1D was not economically viable 
      unless HLA testing and autoantibody testing could be performed for less than $1 
      and $0.03, respectively. CONCLUSIONS: Current screening costs far outweigh the 
      economic benefits of preventing new-onset DKA in children under 5 yr of age.
CI  - (c) 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Meehan, Colette
AU  - Meehan C
AD  - Department of Pediatrics, University of Florida, 1600 SW Archer Road, 
      Gainesville, FL, 32608, USA.
FAU - Fout, Betty
AU  - Fout B
AD  - Abt Associates, 4550 Montgomery Ave., Suite 800 North, Bethesda, MD, 20814, USA.
FAU - Ashcraft, Jordan
AU  - Ashcraft J
AD  - Department of Pediatrics, University of Florida, 1600 SW Archer Road, 
      Gainesville, FL, 32608, USA.
FAU - Schatz, Desmond A
AU  - Schatz DA
AD  - Department of Pediatrics, University of Florida, 1600 SW Archer Road, 
      Gainesville, FL, 32608, USA.
FAU - Haller, Michael J
AU  - Haller MJ
AD  - Department of Pediatrics, University of Florida, 1600 SW Archer Road, 
      Gainesville, FL, 32608, USA.
LA  - eng
PT  - Journal Article
DEP - 20150922
PL  - Denmark
TA  - Pediatr Diabetes
JT  - Pediatric diabetes
JID - 100939345
SB  - IM
MH  - Child, Preschool
MH  - Cost-Benefit Analysis
MH  - Diabetes Mellitus, Type 1/*diagnosis
MH  - Diabetic Ketoacidosis/economics/*prevention & control
MH  - Humans
MH  - Mass Screening/*economics
OTO - NOTNLM
OT  - DKA
OT  - T1D
OT  - screening
EDAT- 2015/09/24 06:00
MHDA- 2016/09/03 06:00
CRDT- 2015/09/23 06:00
PHST- 2015/07/02 00:00 [received]
PHST- 2015/08/17 00:00 [revised]
PHST- 2015/08/17 00:00 [accepted]
PHST- 2015/09/23 06:00 [entrez]
PHST- 2015/09/24 06:00 [pubmed]
PHST- 2016/09/03 06:00 [medline]
AID - 10.1111/pedi.12313 [doi]
PST - ppublish
SO  - Pediatr Diabetes. 2015 Dec;16(8):565-72. doi: 10.1111/pedi.12313. Epub 2015 Sep 
      22.