Predicted costs and outcomes from reduced vibration detection in people with diabetes in the U.S.

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Shearer, A
Scuffham, P
Gordois, A
Oglesby, A
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2003
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Abstract

OBJECTIVE-The ability to perceive vibration (vibration detection) has been shown to be a good predictor of the long-term complications of diabetic peripheral neuropathy (DPN). We aimed to estimate the predicted complications and costs for the U.S. health care system associated with reduced vibration detection (vibration perception threshold =25 V), estimated using a quantitative sensory testing device. RESEARCH DESIGN AND METHODS-A Markov model was constructed for a hypothetical cohort of people with DPN. The model was run over a 10-year period using Monte Carlo simulations to estimate disease progression, predicted costs, and complications according to vibration detection levels. RESULTS-The average individual with reduced vibration detection incurs approximately five times more direct medical costs for foot ulcer and amputations, yields 0.18 fewer quality-adjusted life-years, and lives for ~2 months less than an average individual with normal vibration detection. CONCLUSIONS-The treatment of foot ulceration and amputation is time-consuming and expensive. If individuals with reduced vibration detection could be identified, then preventative care could be concentrated on those patients, potentially saving valuable resources and improving health outcomes.

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Diabetes Care

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26

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8

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Biomedical and clinical sciences

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