2010

Authors

  • Arran Shearer Arran Shearer
  • Paul Scuffham Paul Scuffham
  • Adam Gordois Adam Gordois
  • Alan Oglesby Alan Oglesby

OBJECTIVE-The ability to perceive vibration (vibration detection) has been shown to be a good predictor of the long-term complications of diabetic peripheral neuropathy (DPN). We aimed to estimate the predicted complications and costs for the U.S. health care system associated with reduced vibration detection (vibration perception threshold =25 V), estimated using a quantitative sensory testing device. RESEARCH DESIGN AND METHODS-A Markov model was constructed for a hypothetical cohort of people with DPN. The model was run over a 10-year period using Monte Carlo simulations to estimate disease progression, predicted costs, and complications according to vibration detection levels. RESULTS-The average individual with reduced vibration detection incurs approximately five times more direct medical costs for foot ulcer and amputations, yields 0.18 fewer quality-adjusted life-years, and lives for ~2 months less than an average individual with normal vibration detection. CONCLUSIONS-The treatment of foot ulceration and amputation is time-consuming and expensive. If individuals with reduced vibration detection could be identified, then preventative care could be concentrated on those patients, potentially saving valuable resources and improving health outcomes.