Screening to prevent renal failure in diabetic patients

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7043.1420a (Published 01 June 1996) Cite this as: BMJ 1996;312:1420

Study's assumptions are unwarranted

  1. Knut Borch-Johnsen,
  2. Carl Erik Mogensen,
  3. Eva Ebbehoj,
  4. Helmut Wenzel,
  5. Giancarlo Viberti
  1. Chief physician Centre of Preventive Medicine, DK-2600 Glostrup, Denmark
  2. Professor Physician Medical Department M, Arhus Kommunehospital, Arhus, Denmark
  3. Health economist Boehringer Mannheim, Mannheim, Germany
  4. Professor Guy's Hospital, London SE1 9RT

    EDITOR,—Bryce A Kiberd and Kailash K Jindal questioned the cost effectiveness of microalbuminuria surveillance in patients with insulin dependent diabetes mellitus1 even though previous studies have shown that screening and intervention is likely to have cost benefits.2 These were simulation studies based on a combination of epidemiological data and data from controlled clinical trials, and they were based on assumptions regarding incidence of complications, treatment effects, and the sensitivity and specificity of screening methods. In comparing screening for microalbuminuria with screening for hypertension and persistent proteinuria (both followed by treatment with an angiotensin converting enzyme inhibitor), Kiberd and Jindal made five critical assumptions that are …

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