title: Screen testing cardiovascular prevention in asymptomatic diabetic patients.
abstract: It has recently been proposed that asymptomatic diabetic patients undergo routine screening for subclinical atherosclerotic disease using myocardial perfusion scintigraphy. We herein analyze the expected cost and benefit associated with such a conditional test-treatment strategy (scintigraphic testing followed by statin treatment in positive test responders) in comparison to an unconditional treatment strategy (no testing and statin treatment in all). This analysis shows that unconditional treatment is the dominant strategy, costing 24% less ($3.2 billion) and preventing 25% more (16,800) atherosclerotic events annually on a national basis.
authors.affiliation: Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA. gadiamond@pol.net
authors.forename: George A
authors.initials: GA
authors.lastname: Diamond
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kaul
authors.forename: Prediman K
authors.initials: PK
authors.lastname: Shah
mesh_terms: D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000191:economics* / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D048909:Diabetes Complications / Q000000981:diagnostic imaging* / Q000191:economics* / Q000517:prevention & control; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D008403:Mass Screening / Q000191:economics*; D011877:Radionuclide Imaging
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors