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Economic evaluation of type 2 diabetes prevention programmes: Markov model of low- and high-intensity lifestyle programmes and metformin in participants with different categories of intermediate…

Overview of attention for article published in BMC Medicine, January 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (97th percentile)

Mentioned by

blogs
1 blog
policy
1 policy source
twitter
138 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
25 Dimensions

Readers on

mendeley
140 Mendeley
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Title
Economic evaluation of type 2 diabetes prevention programmes: Markov model of low- and high-intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia
Published in
BMC Medicine, January 2018
DOI 10.1186/s12916-017-0984-4
Pubmed ID
Authors

Samantha Roberts, Dawn Craig, Amanda Adler, Klim McPherson, Trisha Greenhalgh

Abstract

National guidance on preventing type 2 diabetes mellitus (T2DM) in the UK recommends low-intensity lifestyle interventions for individuals with intermediate categories of hyperglycaemia defined in terms of impaired fasting glucose (IFG) or 'at-risk' levels of HbA1c. In a recent systematic review of economic evaluations of such interventions, most studies had evaluated intensive trial-based lifestyle programmes in participants with impaired glucose tolerance (IGT). This study examines the costs and effects of different intensity lifestyle programmes and metformin in participants with different categories of intermediate hyperglycaemia. We developed a decision tree and Markov model (50-year horizon) to compare four approaches, namely (1) a low-intensity lifestyle programme based on current NICE guidance, (2) a high-intensity lifestyle programme based on the US Diabetes Prevention Program, (3) metformin, and (4) no intervention, modelled for three different types of intermediate hyperglycaemia (IFG, IGT and HbA1c). A health system perspective was adopted and incremental analysis undertaken at an individual and population-wide level, taking England as a case study. Low-intensity lifestyle programmes were the most cost-effective (£44/QALY, £195/QALY and £186/QALY compared to no intervention in IGT, IFG and HbA1c, respectively). Intensive lifestyle interventions were also cost-effective compared to no intervention (£2775/QALY, £6820/QALY and £7376/QALY, respectively, in IGT, IFG and HbA1c). Metformin was cost-effective relative to no intervention (£5224/QALY, £6842/QALY and £372/QALY in IGT, IFG and HbA1c, respectively), but was only cost-effective relative to other treatments in participants identified with HbA1c. At a willingness-to-pay threshold of £20,000/QALY, low- and high-intensity lifestyle programmes were cost-effective 98%, 99% and 98% and 81%, 81% and 71% of the time in IGT, IFG and HbA1c, respectively. An England-wide programme for 50-59 year olds could reduce T2DM incidence by < 3.5% over 50 years and would cost 0.2-5.2% of the current diabetes budget for 2-9 years. This analysis suggests that current English national policy of low-intensity lifestyle programmes in participants with IFG or HbA1c will be cost-effective and have the most favourable budget impact, but will prevent only a fraction of cases of T2DM. Additional approaches to prevention need to be investigated urgently.

Twitter Demographics

The data shown below were collected from the profiles of 138 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 140 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 140 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 32 23%
Student > Bachelor 18 13%
Researcher 13 9%
Student > Ph. D. Student 12 9%
Other 7 5%
Other 21 15%
Unknown 37 26%
Readers by discipline Count As %
Medicine and Dentistry 40 29%
Nursing and Health Professions 16 11%
Sports and Recreations 6 4%
Pharmacology, Toxicology and Pharmaceutical Science 6 4%
Economics, Econometrics and Finance 5 4%
Other 26 19%
Unknown 41 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 91. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 27 October 2018.
All research outputs
#365,281
of 21,792,010 outputs
Outputs from BMC Medicine
#288
of 3,191 outputs
Outputs of similar age
#10,116
of 403,028 outputs
Outputs of similar age from BMC Medicine
#1
of 1 outputs
Altmetric has tracked 21,792,010 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,191 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 42.1. This one has done particularly well, scoring higher than 91% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 403,028 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them