Cost-effectiveness analysis of comprehensive intervention programs to control blood glucose in overweight and obese type 2 diabetes mellitus patients based on a real-world setting: Markov modeling

Wang, Hui; Wang, Mengyang; Wang, Jiao; Liu, Hongwei; Lu, Rui; Duan, Tongqing; Gong, Xiaowen; Feng, Siyuan; Cui, Zhuang; Liu, Yuanyuan; Li, Changping; Ma, Jun

doi:10.21037/atm.2019.10.38

Cited by 10 publications

(13 citation statements)

References 17 publications

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“…Most patients have type 2 DM (T2DM). In the past decade, the overall prevalence of DM among Chinese adults has been between 9.7% and 11.6% (2)(3)(4). DM has become a severe disease and poses a significant economic burden on the Chinese Government and its citizens (5).…”

Section: Introductionmentioning

confidence: 99%

Risk prediction of in-hospital mortality among patients with type 2 diabetes mellitus and concomitant community-acquired pneumonia

Sijun¹,

Hou²,

Liu³

et al. 2020

Ann Palliat Med

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Background:The aim of the present study was to investigate the risk factors for in-hospital mortality among patients with type 2 diabetes mellitus (T2DM) and concomitant community-acquired pneumonia (CAP) and establish a risk prediction score. Methods: Data from 1,360 adult patients with T2DM and concomitant CAP hospitalized in two grade 3A hospitals between 2009 and 2019 were collected through electronic medical records. Data obtained included the status of diabetes mellitus, comorbidities, laboratory and imaging findings, and treatment outcomes. Statistical analysis was conducted to investigate the risk factors affecting prognosis, and a clinical risk prediction score was designed. Results: Based on the patients' treatment outcomes (deceased, improved and cured), the cohort was divided into two groups: deceased and improved; 16 parameters were significant after segmentation. However, the following nine parameters were independent predictors of mortality: neutrophil-lymphocyte ratio (NLR) ≥4, pulse rate ≥125 bpm, change in state of consciousness, arterial blood pH ≤7.35, age ≥65 years, serum sodium ≤130 mmol/L, initial fasting blood glucose ≥9 mmol/L, multilobar involvement, and diabetic nephropathy. Based on these findings, a risk prediction score was established, and bootstrap validation was performed. The risk prediction score was significantly superior to CURB-65 [confusion, urea >7 mmol/L, respiratory rate >30/min, low blood pressure (systolic <90 mmHg or diastolic <60 mmHg), age >65 years] and slightly superior than the pneumonia severity index (PSI). Conclusions: The influencing factors for in-hospital mortality among patients with T2DM and concomitant CAP included advanced age, change in state of consciousness, increased pulse rate, acidosis, high NLR, high platelet-lymphocyte ratio, hyponatremia, hyperglycemia, and diabetic nephropathy. These parameters should be recognized in clinical practice, with active interventions to improve the treatment success rate. The risk prediction score effectively differentiated the mortality risk of inpatients, thereby providing guidance on clinical decision-making.

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Section: Introductionmentioning

confidence: 99%

Risk prediction of in-hospital mortality among patients with type 2 diabetes mellitus and concomitant community-acquired pneumonia

Sijun¹,

Hou²,

Liu³

et al. 2020

Ann Palliat Med

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“…A careful search on Google Scholar of articles on pharmacoeconomic analysis on obesity in China (search keywords: pharmacoeconomic AND obesity AND China) published during 2010-2020 yielded 4,250 hits, but only five studies were identified by two of the co-authors as relevant, with obesity as the primary condition studied and China as the study setting [6,[39][40][41][42].…”

Section: Scoping Reviewmentioning

confidence: 99%

“…Another Markov modeling study found that the comprehensive intervention program for blood glucose management of overweight and obese patients with diabetes is cost-effective for the middle-aged male group (ICER of RMB104,000, or $15,147 in 2018US$, per QALY gained) and elderly female group, respectively [42].…”

Section: Cost-effectiveness Analyses Of Obesity Treatmentmentioning

confidence: 99%

Pharmacoeconomics of obesity in China: a scoping review

Jiang

Wang

Khan

et al. 2021

Expert Review of Pharmacoeconomics & Outcomes Research

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Background: With the growing rate of obesity and associated chronic conditions in China, there is a need to assess the health and economic burden of obesity and examine the effectiveness of pharmaceutical, medical, and comprehensive weight-loss interventions.Areas covered: This article reviewed publications retrieved from PubMed and Google Scholar during 2010-2020 on pharmacoeconomic studies related to overweight and obesity in China. We identified five cost-of-illness studies and four cost-effectiveness analyses of weight-loss interventions, including bariatric surgeries and a comprehensive intervention program. Expert opinion:There is a lack of pharmacoeconomic analyses of obesity in China. Existing studies have often taken the health system perspective without accounting for productivity loss.Cohort studies and studies based on electronic health records or claims data are needed to provide the epidemiologic parameters required for homegrown economic evaluations of the health and economic burden of obesity in China, as well as the cost-effectiveness of interventions to reduce obesity and its sequela.

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“…A morbidly obese person is one with a body mass index (BMI) of 35 kg/m 2 or more. China was found by the global population weight survey to have one of the most morbidly obese populations in the world (1). At present, a single dose of propofol is used clinically to induce anesthesia.…”

Section: Introductionmentioning

confidence: 99%

The appropriate dose of propofol for anesthesia induction in morbidly obese patients

Xu¹,

Qiao²,

Pan³

et al. 2020

Ann Palliat Med

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Background: To investigate the optimal dose of propofol in patients with morbid obesity when the anesthetic induction dosage is calculated based on lean body weight (LBW).Methods: Forty morbid obese patients with body mass index (BMI) ≥35 kg/m 2 were randomly divided into two groups: B and M. The sequential method was used in group B to study the EC50 and 95% confidence interval (CI) that met a bispectral index (BIS) value of <50 (the initial dose was set at 2.5 mg/kg). The sequential method was used in group M to obtain the EC50 and 95% CI (the initial dose was set as 3.0 mg/kg) satisfying the mean arterial pressure (MAP) fluctuation margin of >40%. The optimal dose interval of propofol was obtained by synthetically analyzing the results of the two-sequence method.Results: There was no significant difference in the general condition between the two groups (P>0.05).There was no significant change in vital signs from when patients entered the operating room to when sufentanil was infused (P>0.05). The probit model of group B was Y=−5.411+2.343X, the EC50 of positive reaction with BIS <50 was 2.310 mg/kg, and 95% CI was 1.850-2.883 mg/kg. The probit model in the M group was Y=3.275−0.918X, the EC50 of positive reaction that reached >40% of the whole process of anesthetic induction was 3.567 mg/kg, and 95% CI was 1.233-7.165 mg/kg. Conclusions:The appropriate dosage of propofol was 2.310-3.567 mg/kg when the anesthetic induction dosage for patients with morbid obesity was calculated based on LBW. With this dose, the depth of intubation is satisfactory and the hemodynamics are stable.

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Cost-effectiveness analysis of comprehensive intervention programs to control blood glucose in overweight and obese type 2 diabetes mellitus patients based on a real-world setting: Markov modeling

Cited by 10 publications

References 17 publications

Risk prediction of in-hospital mortality among patients with type 2 diabetes mellitus and concomitant community-acquired pneumonia

Risk prediction of in-hospital mortality among patients with type 2 diabetes mellitus and concomitant community-acquired pneumonia

Pharmacoeconomics of obesity in China: a scoping review

The appropriate dose of propofol for anesthesia induction in morbidly obese patients

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