BMJ  2008;336:1140-1141 (24 May), doi:10.1136/bmj.39553.480706.80 (published 21 April 2008)

Editorials

Screening for and prevention of type 2 diabetes

Intervention should be sooner rather than later, even though exact costs and benefits are uncertain

The first 150 words of the full text of this article appear below.

Cost effectiveness models are widely used to help policy makers and clinicians make decisions about alternative interventions. Models have limitations that are well understood—a model is only as reliable, or generalisable, as the assumptions and data that inform it. Moreover, a cost effectiveness model will not deal with questions about feasibility, acceptability, or affordability that may be crucial to decisions about implementation. However, decision analysis models often help to clarify the key factors likely to influence cost effectiveness, so that decision makers can better understand the importance of remaining uncertainties and make more logical decisions in the face of uncertainty.^{1 2}

In the accompanying paper, Gillies and colleagues report a cost effectiveness analysis for screening and prevention of type 2 diabetes.³ They compare four strategies—screening for diabetes; screening for diabetes and impaired glucose tolerance, followed by either lifestyle interventions or drugs; and no screening. Their findings are consistent with the intuitively . . . [Full text of this article]

¹ Regent Court, Sheffield S1 4DA

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