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BMC Med Res Methodol. 2017 Apr 11;17(1):54. doi: 10.1186/s12874-017-0328-2.

Comparison of surveillance-based metrics for the assessment and monitoring of disease detection: simulation study about type 2 diabetes.

Author information

1
German Diabetes Center, Leibniz Institute for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Institute for Biometry and Epidemiology, Auf'm Hennekamp 65, Düsseldorf, 40225, Germany. Ralph.Brinks@ddz.uni-duesseldorf.de.
2
University Hospital at the Heinrich-Heine-University Düesseldorf, Hiller Research Unit for Rheumatology, Moorenstrasse 5, Düsseldorf, 40225, Germany. Ralph.Brinks@ddz.uni-duesseldorf.de.
3
German Diabetes Center, Leibniz Institute for Diabetes Research at the Heinrich-Heine-University Düsseldorf, Institute for Biometry and Epidemiology, Auf'm Hennekamp 65, Düsseldorf, 40225, Germany.
4
Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, Georgia, USA.
5
German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.

Abstract

BACKGROUND:

Screening and detection of cases are a common public health priority for treatable chronic conditions with long subclinical periods. However, the validity of commonly-used metrics from surveillance systems for rates of detection (or case-finding) have not been evaluated.

METHODS:

Using data from a Danish diabetes register and a recently developed illness-death model of chronic diseases with subclinical conditions, we simulate two scenarios of different performance of case-finding. We report different epidemiological indices to assess case-finding in both scenarios and compare the validity of the results.

RESULTS:

The commonly used ratio of detected cases over total cases may lead to misleading conclusions. Instead, the ratio of undetected cases over persons without a diagnosis is a more valid index to distinguish the quality of case-finding. However, incidence-based measures are preferable to prevalence based indicators.

CONCLUSION:

Prevalence-based indices for assessing case-finding should be interpreted with caution. If possible, incidence-based indices should be preferred.

KEYWORDS:

Case-finding; Chronic disease; Compartment model; Diabetes; Incidence; Prevalence; Screening; Undiagnosed disease

PMID:
28399821
PMCID:
PMC5387346
DOI:
10.1186/s12874-017-0328-2
[Indexed for MEDLINE]
Free PMC Article

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