CoChat
Sign Up
Cited by 85Mobile Health and mHealth ApplicationsHealth Systems, Economic Evaluations, Quality of LifeDigital Mental Health Interventions

Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: A systematic review

Open access
Rinaldi, Giulia, Hijazi, Alexa, Haghparast-Bidgoli, Hassan·2020·Diabetes Research and Clinical Practice
DOI 10.1016/j.diabres.2020.108084
Open this paper in CoChat — free accountOpen PDF

Abstract

The prevalence of type 2 diabetes mellitus continues to rise and simultaneously technology has contributed to the growth of MHealth interventions for its prevention, monitoring and management. This systematic review aimed to summarize and evaluate the quality of the published evidence on cost and cost-effectiveness of mHealth interventions for T2DM. A systematic literature search of PubMed, EMBASE, and Web of Science was conducted for papers up to end of April 2019. We included all partial or full economic evaluations providing cost or cost-effectiveness results for mHealth interventions targeting individuals diagnosed with, or at risk of, type 2 diabetes mellitus. Twenty-three studies met the inclusion criteria. Intervention cost varied substantially based on the type and numbers or combination of technologies used, ranging from 1.8 INT $ to 10101.1 INT $ per patient per year. The studies which presented cost effectiveness results demonstrated highly cost-effective interventions, with cost per QALY gained ranging from 0.4 to 62.5 percent of GDP per capita of the country. The quality of partial economic evaluations was on average lower than that of full economic evaluations. Cost of mHealth interventions varied substantially based on type and combination of technology used, however, where cost-effectiveness results were reported, the intervention was cost-effective. PROSPERO registration number: CRD42019123476; Registered: 27/01/2019.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review synthesized 23 studies on the costs and cost-effectiveness of mHealth interventions for preventing and controlling type 2 diabetes mellitus. It found wide cost variation by technology type and combination, but all reported cost-effectiveness results indicated the interventions were cost-effective, while reporting quality was weak, especially among partial economic evaluations.

Key findings

  • Of 23 included studies, 15 (65%) were partial economic evaluations and 8 were full economic evaluations; 3 (13%) were cost-effectiveness analyses, 5 (22%) cost-utility analyses, and no cost-benefit analysis was identified. Fourteen (61%) were randomised controlled trials.
  • Full economic evaluations reported cost-effectiveness ratios ranging from INT$28.4 to INT$1,871 saving per patient per year and from INT$245 to INT$39,167 per QALY gained. All five studies reporting cost per QALY gained were cost-effective by WHO thresholds, with ICERs as percentage of GDP per capita ranging from 0.4% to 62.5%.
  • The only prevention-focused full economic evaluation, by Wong et al., used a text-messaging education service and cost INT$254 per QALY gained, with cost savings of INT$28 per patient per year.
  • Partial economic evaluations reported costs per patient per year from INT$1.8 to INT$10,110 (nine studies) and cost savings per patient per year from INT$61 to INT$7,232 (four studies). Costs varied by number of technologies: one technology INT$1.8–241.0, two technologies INT$61.1–894, and three technologies INT$10.2–10,110.1.
  • Quality assessment found 6 of 8 (75%) full economic evaluations were high quality and 2 (25%) moderate; among partial evaluations, 1 (7%) was high quality, 3 (20%) moderate, and 11 (73%) poor.

Methods

  • Systematic review reported according to PRISMA 2015, with protocol registered in PROSPERO (CRD42019123476). Searches were conducted in MEDLINE/PubMed, EMBASE, and Web of Science up to 30 April 2019, including English-language primary studies published from January 1995 to end of April 2019 that were partial or full economic evaluations of mHealth interventions targeting prevention or management of T2DM.
  • Two reviewers independently screened and extracted data using an adapted extraction tool. Quality of reporting was assessed with the CHEERS checklist for full economic evaluations and a modified CHEERS checklist for partial economic evaluations.
  • Costs and cost-effectiveness ratios were converted to 2018 international dollars using purchasing power parity, consumer price indexes, and World Bank exchange rates, and judged against UK, USA, WHO, and Woods et al. cost-effectiveness thresholds.

Limitations

  • The authors state that only published English-language evidence was included, so publication bias is acknowledged; generalizability must consider country setting, intervention type, and the methodology used to convert costs into 2018 international dollars.
  • The authors report heterogeneity across studies in reported costs, outcome measures, currency, and settings; specialized databases for economic evaluations were not used; and limited relevant papers prevented sub-analysis by income level or geographical region.
  • Evident from the text: all full economic evaluations were based in high-income countries, with none set in low-income settings, and most interventions targeted management rather than prevention, leaving preventative mHealth evidence extremely limited.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.diabres.2020.108084

Cites

61 of 62 references verified0 citation errors · 1 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 24 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Five (22%) full economic evaluations were cost-utility analyses reporting outcomes using QALYs.

    “We also identified five (22%) CUA reporting their outcomes using QALYs.”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Two full economic evaluations using one mHealth technology reported cost per QALY gained values of 0.9% and 0.4% of their respective countries' GDP per capita.

    “Of these, the two studies that used one mHealth technology reported cost per QALY gained had values of 0.9% and 0.4% of their respective countries' GDP per capita [36,37].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [36] source

      Not checked in the free run.

    • cites [37] source

      Not checked in the free run.

    • Rests on an assumption: The included studies' reported costs and cost-effectiveness ratios are sufficiently comparable after conversion to 2018 international dollars to support cross-study comparisons.
  • Findingown data

    Of the 23 included studies, 15 (65%) were partial economic evaluations.

    “Of the studies identified the majority, 15 (65%) were partial economic evaluations.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Of the full economic evaluations, three (13%) were cost-effectiveness analyses reporting costs per natural outcome unit, such as changes in HbA1c.

    “of which three (13%) were CEA reporting the costs of an intervention per a natural outcome unit, for example, changes in HbA1C.”
    Quote in the paperNot a substantial claim
  • Findingown data

    No cost-benefit analysis was identified in the review.

    “No cost benefit analysis was identified in our review.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 22
  • May combine two claims. 26
  • The quote only partly states this claim. 1

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Phone calls were used in 39% of included studies.

    “The next most popular mHealth interventions were phone calls (39%) and text messages (30%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The cost-effectiveness ratios of the eight full economic evaluations ranged from INT$28.4 to INT$1,871 saving per patient per year and from INT$245 to INT$39,167 per QALY gained.

    “The cost-effectiveness ratios of the eight full EEs ranged from INT$ 28.4 to INT$1,871 saving per patient per year and from INT$ 245 to INT$ 39,167 per QALY gained.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The included studies' reported costs and cost-effectiveness ratios are sufficiently comparable after conversion to 2018 international dollars to support cross-study comparisons.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Fourteen (61%) of the included papers were randomised controlled trials.

    “Fourteen (61%) of the included papers were randomised control trials.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    All five full economic evaluations reporting cost per QALY gained were cost-effective according to the WHO threshold, with ICERs as a percentage of GDP per capita ranging from 0.4% to 62.5%.

    “As per the WHO cost-effectiveness threshold all five studies reporting cost per QALY gained were costeffective as ICER as % of GDP per capita ranged from 0.4 to 62.5%.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The included studies' reported costs and cost-effectiveness ratios are sufficiently comparable after conversion to 2018 international dollars to support cross-study comparisons.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Text messages were used in 30% of included studies.

    “The next most popular mHealth interventions were phone calls (39%) and text messages (30%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Eleven (78%) of the included RCTs compared the mHealth intervention to usual care, while three compared it to a non-mHealth intervention.

    “Eleven (78%) of these compared the mHealth intervention to usual care whilst other three compared it to a non-mHealth intervention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The online blood glucose recorder was the most popular mHealth technology, incorporated in 11 out of 23 (48%) studies.

    “Of these, the online blood glucose recorder was the most popular with 11 out of 23 (48%) studies incorporating it into their mHealth intervention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Four of the mHealth interventions were supplemented by non-mHealth components.

    “Interestingly, four of the mHealth interventions were supplemented by non-mHealth components.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingreasoning

    The majority of included papers (74%) were published within the last 10 years.

    “The majority of papers were published within the last 10 years (74%)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The majority of interventions (92%) found were targeting management of diabetes, with only two interventions focusing on prevention of the disease.

    “Another interesting consideration is that the majority of interventions (92%) we found were targeting the management of diabetes with only twos interventions focusing on the prevention of the disease.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Of the 23 included studies, 14 did not perform or specify sensitivity analysis.

    “| Not performed/specified | 14 | 61 |”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    None of the four modelling-based full economic evaluations fully justified why they chose that specific model, and only half described the assumptions underpinning their model.

    “Moreover, none of the four economic evaluations based on modelling fully justified why they chose that specific model and only half of them described the assumptions underpinning their model.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    The Wong et al. text messaging education service cost INT$254 per QALY gained and resulted in cost savings of INT$28 per patient each year.

    “This intervention costed INT$ 254 per QALY gained and resulted in cost savings of INT$ 28 per patient each year.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The majority of included studies were from high-income countries, with none set in low-income settings.

    “The majority of studies were from high-income countries with none set in low-income settings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the fifteen partial economic evaluations, one was rated high quality, three moderate, and eleven poor.

    “Quality High Modera te Poor Moderate Poor Poor Poor Poor Moderate Poor Poor Poor Poor Poor Poor”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Sixteen out of 23 (70%) included studies were RCTs.

    “We also noticed that 16 out of 23 (70%) studies were RCTs”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Six out of eight (75%) included full economic evaluations were deemed high quality according to the CHEERS checklist, and the remaining two (25%) were of moderate quality.

    “To summarize, 6 out of 8 (75%) of the included full economic evaluations were deemed of high quality according to the CHEERS checklist and the remaining 2 (25%) were of moderate quality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the eight full economic evaluations, six were rated high quality and two moderate.

    “Quality High High High Moderate High High Moderate High”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    Of the included studies, 18 were from high-income countries and 5 from middle-income countries; none were from low-income countries.

    “| High | 18 | 78 |”
    • Also stated in: § FIGURE LEGEND · plain
      “| Middle | 5 | 22 |”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Two partial economic evaluations reported other outcomes: one as willingness to pay per month and one as cost per home telemedicine unit.

    “Two studies reported other outcomes; one study represented costs as willingness to pay per month and another as cost per home telemedicine unit.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the 23 included studies, 3 were cost-effectiveness analyses, 5 were cost-utility analyses, and 15 were partial economic evaluations.

    “| CEA | 3 | 13 |”
    • Also stated in: § FIGURE LEGEND · plain
      “| CUA | 5 | 22 |”
    • Also stated in: § FIGURE LEGEND · plain
      “| Partial Economic Evaluations | 15 | 65 |”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among partial economic evaluations, only 1 (7%) was of high quality, 3 (20%) were of moderate quality, and 11 (73%) were assessed as poor quality.

    “Amongst the partial economic evaluations, only 1(7%) was of high quality, whilst 3 (20%) were of moderate quality and 11 (73%) were assessed to be of poor quality.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Quality of reporting of economic evaluation evidence was assessed using the CHEERS checklist for full economic evaluations and a modified CHEERS checklist for partial economic evaluations.

    “The quality of reporting the economic evaluation evidence was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) [26] checklist for full economic evaluations and using a Modified version of CHEERS checklist for partial economic evaluation.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [26] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The systematic review was reported in accordance with the 2015 PRISMA statement.

    “Our systematic review was reported in accordance with the 2015 PRISMA statement [21].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    WHO states that an intervention is highly cost-effective if its cost-effectiveness ratio (cost per DALY averted) is less than GDP per capita and is cost-effective if it is between one and three times GDP per capita.

    “WHO state that an intervention is highly cost-effective if costeffectiveness ratio (cost per disability-adjusted life years-or DALY averted) is less than the gross domestic product (GDP) per capita and is cost-effective if it is between one and three times the GDP per capita [30].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [30]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Two reviewers independently extracted data from included studies using a data extraction tool adapted from existing guidelines and other review articles of economic evaluations.

    “Two reviewers (G.R., A.H.) independently extracted data from the included studies using our data extraction tool adapted from existing guidelines and other review articles of economic evaluations [23][24][25].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23][24][25]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The review protocol was registered with PROSPERO in January 2019 under registration number CRD42019123476 and was published elsewhere.

    “Our protocol was registered with the International Prospective Register of Systematic Reviews in January 2019 (PROSPERO registration number CRD42019123476) and it is published elsewhere [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    mHealth interventions targeting diabetes have shown clinical effectiveness in both the prevention and management of T2DM.

    “MHealth interventions targeting diabetes have shown clinical effectiveness in both the prevention and management of T2DM [13][14][15].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13][14][15]

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    mHealth interventions have proven to be low cost and cost-effective across various medical specialties.

    “MHealth interventions have proven to be low cost and cost-effective across various medical specialties [18,19].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [18] source

      Not checked in the free run.

    • cites [19] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Both GR and AH independently assessed included papers against the checklists, and discrepancies were resolved by discussion and involvement of third author HHB.

    “Both GR and AH independently assessed the included papers against these checklists and any discrepancies were resolved by discussion and involvement of third author (HHB).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the USA, a cost-effectiveness threshold of US$50,000 per QALY gained was used.

    “in the USA US$50,000 per Quality Adjusted Life Years (QALY) gained were used [29].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [29] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    One full economic evaluation integrating two mHealth technologies reported costs per QALY gained equivalent to 7% of GDP per capita in 2018, showing high cost-effectiveness based on WHO thresholds.

    “Whilst the one study that integrated two mHealth technologies reported costs per QALY gained equivalent to 7% of the GDP per capita (2018) showing high cost effectiveness based on the WHO thresholds [38].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [38] source

      Not checked in the free run.

    • Rests on an assumption: The included studies' reported costs and cost-effectiveness ratios are sufficiently comparable after conversion to 2018 international dollars to support cross-study comparisons.

  • May combine two claims.

    Interpretationreasoning

    A simple mHealth intervention using only one type of technology may be the most user friendly and also least costly.

    “Our results seem to agree that often a simple mHealth intervention using only one type of technology may be the most user friendly and also least costly.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The included studies' reported costs and cost-effectiveness ratios are sufficiently comparable after conversion to 2018 international dollars to support cross-study comparisons.

  • May combine two claims.

    Interpretationown data

    The cost of mHealth interventions varied based on the type of intervention, the number of technologies integrated, and whether it was combined with a non-mHealth component.

    “The cost varied based on the type of intervention, the number of technologies integrated and whether it was combined with a non-mHealth component.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The included studies' reported costs and cost-effectiveness ratios are sufficiently comparable after conversion to 2018 international dollars to support cross-study comparisons.

  • May combine two claims.

    Interpretationown data

    Overall, the quality of reporting was weak among both partial and full economic evaluations, but poorer among partial evaluations.

    “Our results have shown that, overall, the quality of reporting was weak among both partial and full economic evaluations, however, poorer amongst partial evaluations.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Poor methodological quality is known to be a major area of weakness for healthcare economic evaluations.

    “Poor methodological quality is known to be a major area of weakness for healthcare economic evaluations [58,59].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [58] source

      Not checked in the free run.

    • cites [59] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two reviewers independently assessed the quality of included studies.

    “GR and AH assessed the quality of included studies independently.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductreasoning

    A third reviewer was involved if there were discrepancies in the assessment of study quality.

    “HHB was involved if there were any discrepancies in the assessment of the study quality.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Lower CHEERS scores might be expected among partial economic evaluations because for 12 out of 15 (80%) the costs were not the primary outcome of the study.

    “Lower CHEERS scores might be expected amongst partial economic evaluations as for 12 out of 15 (80%) the costs were not the primary outcome of the study.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationnone given

    The generalizability of the review's results needs to take into consideration the country setting, type of intervention, and the methodology used to convert costs into 2018 international dollars.

    “We also want to highlight that the generalizability of our results needs to take into consideration the country setting, type of intervention and our methodology used to convert costs into 2018 international dollars.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The included studies' reported costs and cost-effectiveness ratios are sufficiently comparable after conversion to 2018 international dollars to support cross-study comparisons.

  • May combine two claims.

    Study design and conductreasoning

    Only published evidence in the English language was included, so there will be some publication bias within the results.

    “We only included published evidence in the English language, so we acknowledge there will be some publication bias within our results.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The literature search strategy was reviewed by two other authors.

    “GR carried out the literature review of which the strategy was reviewed by AH and HHB.”
    Quote in the paperNot a substantial claim
42 of 42

  • The paper relies on this without support.

    There is currently no published literature summarising the cost or cost-effectiveness of mHealth interventions targeting the prevention and control of T2DM.

    “To the best of our knowledge, there is currently no published literature summarising the cost or cost-effectiveness of mHealth interventions targeting the prevention and control of T2DM.”

  • The paper relies on this without support.

    The included studies' reported costs and cost-effectiveness ratios are sufficiently comparable after conversion to 2018 international dollars to support cross-study comparisons.

    “To allow for comparability across time and settings we converted all costs and costeffectiveness ratios to 2018 international dollars (INT$) using purchasing power parity, consumer price indexes and currency exchange rates form the World Bank Open Database 39 .”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • For glycemic control, telehealth appears to be as good as or superior to traditional health care delivery in persons with type 1 or type 2 diabetes, especially those needing more interactions, newly diagnosed, with higher A1C, with gestational diabetes, or with other comorbid conditions.

    “With respect to glycemic control, telehealth appears noninferior (as good or superior) to traditional health care delivery for persons with T1D or T2D, particularly in those who require more interactions, are newly diagnosed, have higher A1C levels, are diagnosed with GDM, or have other comorbid conditions.1673–1681”

    From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1673]

    Section 1.3 reports improved glycemic control with mHealth interventions for people with type 2 diabetes, and Section 3.1 says many included trials compared mHealth with usual care. The paper does not establish the stated general noninferiority of telehealth for both type 1 and type 2 diabetes, or identify greater benefit in the listed subgroups, including gestational diabetes. No page numbers are available in our copy. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Lifestyle interventions, including dietary modifications and physical activity programs, are clinically effective and cost-effective in preventing and managing T2D.

    “Recent systematic reviews and meta-analyses have demonstrated that lifestyle interventions, including dietary modifications and physical activity programs, are clinically effective and cost-effective in preventing and managing T2D [8,9].”

    From Economic evaluation of wearable fitness trackers versus metformin for preventing type 2 diabetes in the UK population (2025) · cites this paper as [9]

    Section 1.3 reports clinical effectiveness of mHealth interventions for T2D prevention and management, and the Conclusion says that interventions with reported cost-effectiveness results were highly cost-effective. The review evaluates technology-based interventions, not dietary modifications and physical activity programs generally; its Discussion also says evidence for preventive mHealth interventions remains extremely limited. It therefore does not establish the claim for lifestyle interventions as a whole. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Meta-analyses on T2DM indicate that despite substantial cost variations in DHIs due to technology types and device combinations, these interventions tend to demonstrate high cost-effectiveness.

    “meta-analyses on T2DM indicate that despite substantial cost variations in DHIs due to technology types and device combinations, these interventions tend to demonstrate high cost-effectiveness (52)”

    From The effectiveness of digital health intervention on glycemic control and physical activity in patients with type 2 diabetes: a systematic review and meta-analysis (2025) · cites this paper as [52]

    The Conclusion (section 5.0) says costs varied substantially by the type and combination of technologies, and that interventions were highly cost-effective where cost-effectiveness results were reported. The cited paper is a systematic review, not a meta-analysis, and it limits the cost-effectiveness finding to studies that reported those results. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Two different GDP-per-capita percentages for Gordon intervention

    Minor

    The results describe the two-technology cost per QALY as 7% of GDP per capita, while Table 2 reports 7.7% for Gordon et al. Rounding 7.7% to a whole percent would give 8%, not 7%.

  • Wong intervention has two different costs per QALY

    Minor

    The results state INT$254 per QALY gained for Wong et al., but Table 2 reports INT$245.1 for the same intervention. The difference is not rounding.

2 of 2

Cites

Flagged first, then by citations

1 of the 63 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Gordon, 2014, A cost-effectiveness analysis of a telephone-linked care intervention for individuals with Type 2 diabetes, Diabetes Res Clin Pract, 104, 103, 10.1016/j.diabres.2013.12.032 · DOI · Paper page

Cited by

Sorted by citations

Related

Authors
Rinaldi, G., Hijazi, A., & Haghparast-Bidgoli, H.
Affiliations
  • Guy's and St Thomas' NHS Foundation Trust (GB)
  • University College London (GB)
Corresponding author
Rinaldi, Giulia
ORCID
Rinaldi, Giulia
Venue
Diabetes Research and Clinical Practice
Publisher
Elsevier BV
Published
2020-04
Volume
162
Pages
108084
ISSN
0168-8227 (ISSN-L)
DOI
10.1016/j.diabres.2020.108084
OpenAlex
W3006013728
Semantic Scholar
b0f078f13bc29aa6d9ffc1fe4846e074425f8398
Cited by
85
References
63
Citations by year
2026: 9 · 2025: 15 · 2024: 13 · 2023: 16 · 2022: 18 · 2021: 10 · 2020: 4
FWCI
2.28
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Research and Clinical Practice (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
mobile health intervention, type 2 diabetes, diabetes prevention, diabetes management, cost-effectiveness, cost per QALY, economic evaluation quality, mobile health technology, diabetes risk
MeSH terms
Cost-Benefit Analysis, Diabetes Mellitus, Type 2, Humans, Telemedicine

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review