Screening strategies for adults with type 2 diabetes mellitus : a systematic review protocol
Date
2020-07-13
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: There is limited evidence on whether screening for type 2 diabetes mellitus affects health outcomes.
A recent systematic review of randomised clinical trials found only one trial that met their inclusion criteria;
therefore, current guidelines for screening interventions for type 2 diabetes mellitus are based on expert opinions
and best practice rather than synthesised evidence. This systematic review seeks to collate evidence from nonrandomised
studies to investigate the effect of screening for adults with type 2 diabetes on outcomes including
diabetes-related morbidity, mortality (all-cause and diabetes-related) and harms.
Methods: This systematic review will follow Effective Practice and Organisation of Care (EPOC) guidelines for the
synthesis of non-randomised studies. We will search PubMed/MEDLINE, Scopus, Web of Science, CINAHL, Academic
Search Premier and Health Source Nursing Academic (from inception onwards). We will include non-randomised
trials, controlled before-after studies, interrupted time-series studies, repeated measures studies and concurrently
controlled prospective cohort studies. The primary outcome will be diabetes-related morbidity (microvascular
complications of diabetic retinopathy, nephropathy or neuropathy or macrovascular complications of non-fatal
myocardial infarction, peripheral arterial disease or non-fatal stroke). The secondary outcomes will be mortality (allcause
and diabetes-related) and harms of screening strategies to patients (including psychological harms or adverse
events following treatments) or to health care system (including resource allocation for false-positives or
overdiagnosis). Two reviewers will independently screen all citations and full-text articles. Data will be abstracted by
one reviewer and checked by a second. The risk of bias of individual studies will be appraised using the ROBINS-I
tool. GRADE will be used to determine the quality of the scientific evidence. If feasible, we will conduct random
effects meta-analysis where appropriate. If necessary, analyses will be conducted to explore the potential sources of
heterogeneity (e.g. age, sex, socio-economic status, rural versus urban or low-middle income versus high-income
country). We will disseminate the findings via publications and through relevant networks.
Discussion: The protocol outlines the methods for systematically reviewing and synthesising evidence of screening
strategies for type 2 diabetes mellitus and their effect on health outcomes associated with the disease. The
potential impact of this systematic review is improved evidence-informed decision-making for policies and practice
for screening of type-2 diabetes.
Description
CITATION: Mearns, H., et al. 2020. Screening strategies for adults with type 2 diabetes mellitus : a systematic review protocol. Systematic Reviews, 9:156, doi:10.1186/s13643-020-01417-3.
The original publication is available at https://systematicreviewsjournal.biomedcentral.com
The original publication is available at https://systematicreviewsjournal.biomedcentral.com
Keywords
Medical screening, Non-insulin-dependent diabetes -- Testing, Non-insulin-dependent diabetes -- Patients -- Adults, Systematic reviews (Medical research)
Citation
Mearns, H., et al. 2020. Screening strategies for adults with type 2 diabetes mellitus : a systematic review protocol. Systematic Reviews, 9:156, doi:10.1186/s13643-020-01417-3