JDRF, New York, NY.
The Leona M. and Harry B. Helmsley Charitable Trust, New York, NY.
Diabetes Care. 2021 Feb;44(2):332-339. doi: 10.2337/dc20-0927. Epub 2020 Dec 10.
The purpose of this study was to use a discrete-choice experiment methodology to understand the relative importance of the attributes of screening tests for type 1 diabetes among parents and pediatricians in the U.S.
Online surveys presented hypothetical screening test profiles from which respondents chose their preferred test profile. Survey attributes were based on likely screening test options and included the mode of administration, where and when the test was conducted, the type of education and monitoring available to lower the risk of diabetic ketoacidosis (DKA), and whether a treatment was available that would delay onset of insulin dependence. Data were analyzed using random-parameters logit models.
Parents placed the highest relative importance on monitoring programs that could reduce the risk of DKA to 1%, followed by treatment to delay onset of insulin dependence by 1 or 2 years, and, finally, avoiding a $50 out-of-pocket cost. Pediatricians placed equal importance on monitoring programs that reduced a patient's risk of DKA to 1% and on avoiding a $50 out-of-pocket cost for the screening test, followed by the option of a treatment to delay the onset of insulin dependence. The mode of administration and location and timing of the screening were much less important to parents and pediatricians.
Parents and pediatricians preferred screening tests that were accompanied by education and monitoring plans to reduce the risk of DKA, had available treatment to delay type 1 diabetes, and had lower out-of-pocket costs.
本研究旨在采用离散选择实验方法来了解美国父母和儿科医生对 1 型糖尿病筛查测试属性的相对重要性。
在线调查呈现了假设的筛查测试概况,受访者从中选择他们偏爱的测试概况。调查属性基于可能的筛查测试选项,包括管理模式、进行测试的地点和时间、提供的降低糖尿病酮症酸中毒(DKA)风险的教育和监测类型,以及是否有可延迟胰岛素依赖发生的治疗方法。使用随机参数逻辑模型对数据进行分析。
父母最看重可将 DKA 风险降低至 1%的监测方案,其次是可将胰岛素依赖发生时间延迟 1 年或 2 年的治疗方法,最后是避免 50 美元的自付费用。儿科医生对将患者 DKA 风险降低至 1%的监测方案和避免 50 美元的筛查测试自付费用同等重视,其次是可延迟胰岛素依赖发生的治疗方法。管理模式以及筛查的地点和时间对父母和儿科医生的重要性要低得多。
父母和儿科医生更喜欢伴有教育和监测计划以降低 DKA 风险、有可延迟 1 型糖尿病发生的治疗方法且自付费用较低的筛查测试。