IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0227694.html
   My bibliography  Save this article

Can a semi-quantitative method replace the current quantitative method for the annual screening of microalbuminuria in patients with diabetes? Diagnostic accuracy and cost-saving analysis considering the potential health burden

Author

Listed:
  • Yaerim Kim
  • Seokwoo Park
  • Myung-Hee Kim
  • Sang Hoon Song
  • Won Mok Lee
  • Hye Soon Kim
  • Kyubok Jin
  • Seungyeup Han
  • Yong Chul Kim
  • Seung Seok Han
  • Hajeong Lee
  • Jung Pyo Lee
  • Kwon Wook Joo
  • Chun Soo Lim
  • Yon Su Kim
  • Dong Ki Kim

Abstract

Objectives: Diabetes is a global epidemic, and the high cost of annually and quantitatively measuring urine albumin excretion using the turbidimetric immunoassay is challenging. We aimed to determine whether a semi-quantitative urinary albumin-creatinine ratio test could be used as a screening tool for microalbuminuria in diabetic patients. Methods: We assessed the diagnostic accuracy of the semi-quantitative method. The costs of false results in the semi-quantitative method were calculated based on the annual probability of disease progression analyzed through a systematic literature review and meta-analysis. The pooled long-term cost-saving effect of the semi-quantitative method compared with the quantitative test was assessed using a Markov model simulating a long-term clinical setting. Diagnostic accuracy and the cost-saving effect were also validated in an independent external cohort. Results: Compared with the quantitative test, the semi-quantitative method had sensitivities of 93.5% and 81.3% and specificities of 61.4% and 63.1% in the overall sample of diabetic patients (n = 1,881) and in diabetic patients with eGFR ≥60 ml/min/1.73 m2 and a negative dipstick test (n = 1,110), respectively. After adjusting for direct and indirect medical costs, including the risk of disease progression, which was adjusted by the meta-analyzed hazard ratio for clinical outcomes, it was determined that using the semi-quantitative method could save 439.4 USD per person for 10 years. Even after adjusting the result to the external validation cohort, 339.6 USD could be saved for one diabetic patient for 10 years. Conclusions: The semi-quantitative method could be an appropriate screening tool for albuminuria in diabetic patients. Moreover, it can minimize the testing time and inconvenience and significantly reduce national health costs.

Suggested Citation

  • Yaerim Kim & Seokwoo Park & Myung-Hee Kim & Sang Hoon Song & Won Mok Lee & Hye Soon Kim & Kyubok Jin & Seungyeup Han & Yong Chul Kim & Seung Seok Han & Hajeong Lee & Jung Pyo Lee & Kwon Wook Joo & Chu, 2020. "Can a semi-quantitative method replace the current quantitative method for the annual screening of microalbuminuria in patients with diabetes? Diagnostic accuracy and cost-saving analysis considering ," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-17, January.
    • Handle: RePEc:plo:pone00:0227694
    DOI: 10.1371/journal.pone.0227694
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227694
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0227694&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0227694?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Olson, Mancur & Bailey, Martin J, 1981. "Positive Time Preference," Journal of Political Economy, University of Chicago Press, vol. 89(1), pages 1-25, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Vipul Bhatt & Masao Ogaki & Yuichi Yaguchi, 2017. "Introducing Virtue Ethics into Normative Economics for Models with Endogenous Preferences," RCER Working Papers 600, University of Rochester - Center for Economic Research (RCER).
    2. J Pentecost Eric & Ramlogan Carlyn, 2000. "The Savings Ratio and Financial Repression in Trinidad and Tobago," International Economic Journal, Taylor & Francis Journals, vol. 14(2), pages 67-84.
    3. Pavel Potužák, 2016. "Fisher and Mises on Zero Interest: A Reconsideration," Prague Economic Papers, Prague University of Economics and Business, vol. 2016(2), pages 203-220.
    4. Víctor J Elías, 1984. "Una Nota sobre la Elasticidad del Ahorro con Respecto a la Tasa de Interés," Latin American Journal of Economics-formerly Cuadernos de Economía, Instituto de Economía. Pontificia Universidad Católica de Chile., vol. 21(62), pages 83-90.
    5. Molla Alemayehu & Joost Beuving & Ruerd Ruben, 2019. "Disentangling Poor Smallholder Farmers’ Risk Preferences and Time Horizons: Evidence from a Field Experiment in Ethiopia," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 31(3), pages 558-580, July.
    6. Häggquist, Elisabeth & Söderholm, Patrik, 2015. "The economic value of geological information: Synthesis and directions for future research," Resources Policy, Elsevier, vol. 43(C), pages 91-100.
    7. Cui, Xiaoyong & Gong, Liutang & Yang, Jianfang & Zou, Heng-fu, 2008. "Marshallian time preferences and monetary non-neutrality," Economic Modelling, Elsevier, vol. 25(6), pages 1196-1205, November.
    8. Gunatilake, H.M & Wickramasinghe, W.A.R & Abeygunawardena, P., 2009. "Time Preference and Natural Resource Use by Local Communities: The Case of Sinharaja Forest in Sri Lanka," Sri Lankan Journal of Agricultural Economics, Sri Lanka Agricultural Economics Association (SAEA), vol. 10, pages 1-31.
    9. Pasquale Scaramozzino & Giancarlo Marini, 2000. "Social time preference," Journal of Population Economics, Springer;European Society for Population Economics, vol. 13(4), pages 639-645.
    10. Richard M. Peck & Padmanabhan Srinagesh, 1986. "Time Preference and Uncertain Lifetime1," The American Economist, Sage Publications, vol. 30(2), pages 41-45, October.
    11. Abbas Mirakhor, 1993. "Equilibrium in a Non-Interest Open Economy التوازن في اقتصاد مفتوح خال من الربا," Journal of King Abdulaziz University: Islamic Economics, King Abdulaziz University, Islamic Economics Institute., vol. 5(1), pages 3-23, January.
    12. Lee Endress & Sittidaj Pongkijvorasin & James Roumasset & Basharat Pitafi, 2009. "Impatience and Intergenerational Equity in a Model of Sustainable Growth," Working Papers 200906, University of Hawaii at Manoa, Department of Economics.
    13. Tanweer Akram, 2015. "The Malady of Low Global Interest Rates," Economics Working Paper Archive wp_852, Levy Economics Institute.
    14. Pavel Potu?ák, 2021. "The Optimum Allocation of Consumption of the Fisherian Shipwrecked Sailors," International Journal of Economic Sciences, European Research Center, vol. 10(2), pages 114-125, December.
    15. James A Roumasset & Lee H Endress, 2000. "Sustainable Development Without Constraints," Working Papers 200009, University of Hawaii at Manoa, Department of Economics.
    16. Buchholz, Wolfgang & Schumacher, Jan, 2010. "Discounting and welfare analysis over time: Choosing the [eta]," European Journal of Political Economy, Elsevier, vol. 26(3), pages 372-385, September.
    17. Mareike Schad & Jürgen John, 2012. "Towards a social discount rate for the economic evaluation of health technologies in Germany: an exploratory analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 127-144, April.
    18. Bullard, James & Russell, Steven, 1999. "An empirically plausible model of low real interest rates and unbacked government debt," Journal of Monetary Economics, Elsevier, vol. 44(3), pages 477-508, December.
    19. Chateauneuf, Alain & Rebille, Yann, 2004. "Some characterizations of non-additive multi-period models," Mathematical Social Sciences, Elsevier, vol. 48(3), pages 235-250, November.
    20. Kotlikoff, Laurence J, 1984. "Taxation and Savings: A Neoclassical Perspective," Journal of Economic Literature, American Economic Association, vol. 22(4), pages 1576-1629, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0227694. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.