PubMed Health⌕ Search

Biomedical subjects

G Worrall

Publications and source records attributed to G Worrall.

9 recordsLinked to original sources
PubMed1991

Screening healthy people for diabetes: is it worthwhile?

BACKGROUND: The objectives of this study were (1) to estimate the prevalence of previously unknown diabetes mellitus in an apparently healthy population aged 40 years and older, (2) to estimate the ratio of known to unknown diabetics, and (3) from this information, to estimate the true prevalence of diabetes. METHODS: A one in five random sample of healthy patients aged 40 years and older attending six rural family physician offices had their fasting plasma glucose (FPG) level tested with a reflectance glucometer. If the FPG was greater than or equal to 7.8 mmol/L (140.5 mg/dL), a second FPG test was done on a later day. RESULTS: The sample of 1264 patients contained 139 known patients with diabetes. Of the remaining 1125 patients, 936 (83%) were tested. Twenty-three patients had an elevated FPG level on the first test, but only nine of them had an elevated FPG level on the second test. One new patient with diabetes was found for each 15 patients already diagnosed; thus, the prevalence of unknown diabetes in the study population was 0.7%. As a result of this survey, the estimated prevalence of diabetes in the population age 40 years and older rose from 11.0% to 11.7%, and the estimated prevalence for the entire population rose from 4.4% to 4.6%. CONCLUSIONS: Routine screening for diabetes mellitus in otherwise healthy patients aged 40 years and older is not worthwhile. Such screening should be restricted to high-risk groups.

Adult↗
PubMed1990

Early detection of depression by primary care physicians.

The overall prevalence of depression is from 3.5% to 27%. The burden of suffering is high and includes death through suicide. In most cases treatment is effective, but important episodes of depression are being missed. To determine whether a brief, systematic assessment for the early detection of depression should be part of the periodic health examination we searched MEDLINE and the Science Citation Index for randomized controlled trials that evaluated the effectiveness of early detection of depression with a questionnaire. Seven instruments met our quality criteria; the Beck Depression Inventory, the Center for Epidemiologic Studies Depression Scale, the Zung Self-Assessment Depression Scale, the General Health Questionnaire, the Hopkins Symptom Checklist, the Mental Health Inventory and the Hospital Anxiety and Depression Scale. The four randomized controlled trials failed to provide adequate evidence of the benefit of routine screening. Early detection is difficult because of depression's natural history, the role of symptoms, the cultural diversity of Canada and how detection instruments have been developed. Depression deserves careful attention from primary care physicians; however, further research and development is required before the widespread routine use of any detection test can be recommended.

Adult↗
PubMedDate not supplied

The ratio of diagnosed to undiagnosed diabetes in patients 40 years and older.

A cross-sectional survey of a one in five random sample of apparently healthy adults aged 40 years and older was done in 17 family practice clinics in Newfoundland, in order to pick up previously undiagnosed diabetics, by fasting blood sugar (FBS) measurements. From a sample of 2,087 people, 1,767 were tested. Forty-eight persons had an elevated FBS on the first test, but only 19 had a sustained high FBS when a second test was done. There were 16 previously-known diabetics for each new diabetic found; in this population it was not worth screening healthy persons for diabetes. Testing should be restricted to high-risk people only. As a result of this study, the diabetes prevalence in the 40+ population rose from 12.4% to 13.1%.

Adult↗
PubMedDate not supplied

A minimal prevalence study of diagnosed diabetes in Newfoundland and Labrador.

A two-stage random probability sampling survey of the medical charts of family physicians in Newfoundland and Labrador was done; the first stage sampled physicians randomly, in proportion to the 5 health districts of the province; the second stage took a quota sample of the physicians' charts. The survey revealed a total population minimal prevalence rate of diagnosed diabetics of 3.55% (95% confidence limits 2.55, 4.55). This rate is higher than that found in the only other provincial survey done in Canada (the Prince Edward Island survey). Of diagnosed diabetics, 40% were found to be using insulin. This proportion is higher than other rates in North America. The prevalence rate was slightly higher in males (3.7%) than in females (3.4%).

Age Factors↗