糖尿病专家对糖尿病预防研究的推理：一项问卷调查

Diabetes experts' reasoning about diabetes prevention studies: a questionnaire survey.

作者信息

Mühlhauser Ingrid

机构信息

Unit of Health Sciences, University of Hamburg, Hamburg, Germany.

出版信息

BMC Res Notes. 2008 Oct 14;1:90. doi: 10.1186/1756-0500-1-90.

DOI:10.1186/1756-0500-1-90

PMID:18854022

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2588450/

Abstract

BACKGROUND

Presentation of results of diabetes prevention studies as relative risk reductions and the use of diagnostic categories instead of metabolic parameters leads to overestimation of effects on diabetes risk. This survey examines to what extent overestimation of diabetes prevention is related to overestimation of prevention of late complications.

METHODS

Participants of two postgraduate courses in clinical diabetology in Austria (n = 69) and Germany (n = 31) were presented a questionnaire with 8 items at the beginning of the meetings. All 100 questionnaires were returned with 92 filled in completely. Participants were asked 1) to rate the importance of differently framed results of prevention studies and, for comparison, of the United Kingdom Prospective Diabetes Study (UKPDS), 2) to estimate to what extent late complications could be prevented by the achieved reductions in diabetes risk or HbA1c values, respectively.

RESULTS

Prevention of diabetes by 60% was considered important by 84% of participants and 35% thought that complications could be prevented by >/= 55%. However, if corresponding HbA1c values were presented (6.0% versus 6.1%) only 19% rated this effect important, and 12% thought that late complications could be prevented by >/= 55%. The difference in HbA1c of 0.9% over 10 years in the UKPDS was considered important by 75% of participants and 16% thought that complications ('any diabetes related endpoint') were reduced by >/= 55% (correct answer <15% by 20% participants).

CONCLUSION

The novel key message of this study is that the misleading reporting of diabetes prevention studies results in overestimation of effects on late complications.

摘要

背景

将糖尿病预防研究结果呈现为相对风险降低，以及使用诊断类别而非代谢参数，会导致对糖尿病风险影响的高估。本调查研究了糖尿病预防的高估在多大程度上与晚期并发症预防的高估相关。

方法

在奥地利（n = 69）和德国（n = 31）的两个临床糖尿病学研究生课程的参与者在课程开始时收到一份包含8个条目的问卷。所有100份问卷均被退回，其中92份填写完整。参与者被要求：1）对预防研究不同表述结果以及作为对照的英国前瞻性糖尿病研究（UKPDS）结果的重要性进行评分；2）分别估计通过实现的糖尿病风险降低或糖化血红蛋白（HbA1c）值降低，晚期并发症可以预防的程度。

结果

84%的参与者认为糖尿病预防60%很重要，35%的人认为并发症可以预防≥55%。然而，如果呈现相应的HbA1c值（6.0%对6.1%），只有19%的人认为这种效果重要，12%的人认为晚期并发症可以预防≥55%。UKPDS中10年内0.9%的HbA1c差异，75%的参与者认为很重要，16%的人认为并发症（“任何糖尿病相关终点”）降低了≥55%（正确答案是<15%，20%的参与者答对）。