BLOOD DONORS AND BLOOD COLLECTION
Screening blood donors for diabetes: analysis of use, accuracy, and cost
Article first published online: 3 MAR 2013
© 2013 American Association of Blood Banks
Volume 53, Issue 11, pages 2776–2781, November 2013
How to Cite
Lenhard, M. J., Maser, R. E., Kolm, P., Healy, M. J. and Seshadri, P. (2013), Screening blood donors for diabetes: analysis of use, accuracy, and cost. Transfusion, 53: 2776–2781. doi: 10.1111/trf.12135
- Issue published online: 13 NOV 2013
- Article first published online: 3 MAR 2013
- Manuscript Revised: 7 JAN 2013
- Manuscript Accepted: 7 JAN 2013
- Manuscript Received: 29 JUL 2012
- Clinical Research Committee of the Christiana Care Health System
The objective was to determine if a free, voluntary diabetes screening program as a part of the blood donation process might be cost-effective.
Study Design and Methods
During the first 6 months of the program, 26,415 donors were screened using a single random plasma glucose (RPG) level. All donors were asked to eat before donation. Low-, moderate-, and high-risk groups were formed based on RPG levels (<140, 140-200, and >200 mg/dL). Contact with a telephone questionnaire was made with 139 of 178 (78%) of the persons in the high-risk group with 33 new cases of diabetes diagnosed by the donor's physician and 26 donors indicating that they were not diagnosed with diabetes. Sex- and age-matched donors in the low- and moderate-risk groups were contacted and administered the same questionnaire.
The three risk groups were similar, except for body mass index (28.1 ± 5.4 kg/m2 vs. 29.9 ± 5.5 kg/m2 vs. 32.7 ± 5.6 kg/m2, p < 0.001). The discriminative effectiveness of screening was evaluated by the area under the receiver operating characteristics (AROC) curve. The AROC curve was 0.950 (95% confidence interval, 0.920-0.979) for the identification of diabetes. Using a RPG cutoff of 200 mg/dL, sensitivity was 100%, specificity was 82%, and positive predictive value was 56%. Cost analyses showed that the mean cost to screen, per donor, was less than $1. Cost per case identified was estimated to be less than $500 for a RPG cutoff of 200 mg/dL.
Screening during the blood donation process appears to be accurate, convenient, and inexpensive.