Selection Criteria For Studies

Studies are included if they were either randomized controlled trials (RCTs) or community-based trials, or if they were large, prospective epidemiological studies of sufficient rigor and generalizability to be useful. Some of the historically important studies in diabetes prevention do not meet these criteria for quality but they are mentioned for completeness, with comments about their design or conduct. The numerous clinical, ecological, cross-sectional and retrospective studies that have been conducted have been largely omitted, unless they provide the only evidence bearing on an issue.

Studies were identified through computerized searches of several databases, including Medline, CINAHL, Health Plan, PsycLIT, Helmis, Cochrane Collaboration and Best Evidence. Standard MESH terms were often only partially successful in identifying relevant articles, which were primarily found through a combination of searching published reference lists and contacts with investigators. Unpublished prevention trials were sought through contacts with researchers, although none were found that had been completed but not published. Trials in progress are included in a later section of this chapter. Classification of evidence used in this chapter is shown in Table 6.1, which is based on the US Preventive Service Task Force Criteria28 for individual studies, and NHLBI (National Heart, Lung and Blood Institute of the NIH) evidence criteria29 for overall recommendations.

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