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首页> 外文期刊>BMC Family Practice >Diabetes screening with hemoglobin A1c prior to a change in guideline recommendations: prevalence and patient characteristics
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Diabetes screening with hemoglobin A1c prior to a change in guideline recommendations: prevalence and patient characteristics

机译：在进行指南改变之前，糖尿病用血红蛋白A1C筛选：患病率和患者特征

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Background In January 2010, the American Diabetes Association recommended the use of hemoglobin A1c (Hgb A1c) to screen and diagnose diabetes. This study explored the prevalence and clinical context of Hgb A1c tests done for non-diabetic primary care patients for the three years prior to the release of the new guidelines. We sought to determine the provision of tests in non-diabetic patients age 19 or over, patients age 45 and over (eligible for routine diabetes screening), the annual change in the rate of this screening test, and the patient characteristics associated with the provision of Hgb A1c screening. Methods We conducted a retrospective study using data routinely collected in Electronic Medical Records. The participants were thirteen community-based family physicians in Toronto, Ontario. We calculated the proportion of non diabetic patients who had at least one Hbg A1c done in three years. We used logistic generalized estimating equation with year treated as a continuous variable to test for a non-zero slope in yearly Hbg A1c provision. We modelled screening using multivariable logistic regression. Results There were 11,792 non-diabetic adults. Of these, 1,678 (14.2%; 95%CI 13.6%-14.9%) had at least one Hgb A1c test done; this was higher for patients 45 years of age or older (20.2%; 95% CI 19.3% - 21.2%). The proportion of non-diabetic patients with an A1c test increased from 5.2% in 2007 to 8.8% in 2009 (p Conclusions A large and increasing proportion of the non-diabetic patients we studied have had an Hgb A1c for screening prior to guidelines recommending the test for this purpose. Several risk factors for cardiovascular disease or diabetes were associated with the provision of the Hgb A1c. Early uptake of the test may represent appropriate utilization.
机译：背景技术2010年1月，美国糖尿病协会建议使用血红蛋白A1C（HGB A1C）筛选和诊断糖尿病。本研究探讨了在释放新指南之前的三年内为非糖尿病初级护理患者进行HGB A1C测试的患病率和临床背景。我们试图确定19岁或以上的非糖尿病患者的测试，45岁及以上患者（有资格获得常规糖尿病筛查），该筛查试验率的年度变化以及与规定相关的患者特征HGB A1C筛选。方法采用在电子医疗记录中常规收集的数据进行了回顾性研究。参与者是安大略省多伦多的十三个社区家庭医生。我们计算了在三年内完成至少一个HBG A1C的非糖尿病患者的比例。我们使用与年度视为连续变量的物流广义估计方程，以测试每年的HBG A1C提供的非零斜率。我们使用多变量逻辑回归建模筛选。结果有11,792名非糖尿病成年人。其中，1,678（14.2％; 95％CI 13.6％-14.9％）进行了至少一种HGB A1C测试;对于45岁或以上的患者（20.2％; 95％CI 19.3％ - 21.2％），这更高。非糖尿病患者A1C试验的比例从2007年的5.2％增加到2009年的8.8％（P我们所学习的非糖尿病患者的大量和增加比例较大，在建议之前，有一个HGB A1C用于筛选为此目的进行测试。患有心血管疾病或糖尿病的几个危险因素与提供HGB A1C有关。测试的早期摄取可能代表适当的利用率。

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