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Comparison of surveillance-based metrics for the assessment and monitoring of disease detection: simulation study about type 2 diabetes
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Details:
  • Pubmed ID:
    28399821
  • Pubmed Central ID:
    PMC5387346
  • Description:
    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.

    Electronic supplementary material

    The online version of this article (doi:10.1186/s12874-017-0328-2) contains supplementary material, which is available to authorized users.

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