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Table 1 Advantages and disadvantages of tools that might be used to screen patients with T2D for UDCI

From: Unrecognised cardiovascular disease in type 2 diabetes: is it time to act earlier?

Tool Advantages Disadvantages
Questionnaires Can be carried out by a variety of people with limited affect to its validity and reliability
Results can be quickly and easily quantified
Can be analysed more ‘scientifically’ and objectively than other forms of research
Can be used to compare and contrast data and to measure change
Patients may provide the answers that they think are expected
Lacks validity
It is difficult to assess how much thought a patient has given to each question
The interpretation of each question may differ
Digital data gathering (e.g. wearable personal health tracker) Provide continuous, objective, remote monitoring
Patients can monitor and self-manage behaviours
A significant volume of data can be captured
Data collected may promote beneficial lifestyle changes
Accuracy may be affected by factors such as individual gait characteristics, body morphology, and where and how a device is worn on the body
Patients may place greater faith in the accuracy of the device than is warranted
Sensitive data may be captured with resultant privacy issues
Stress test or 6-minute walking test Practical and simple requiring no specialised equipment
Evaluates the global and integrated responses of all the systems involved during exercise
Useful for measuring the response to medical interventions
Findings are reproducible
Additional cardiopulmonary exercise testing may be required
Adherence to strict protocols is required to ensure validity of data collected
Biomarkers Free from recall bias
Can provide sensitive and specific early detection of disease
Usually require a sample of body fluid to be taken
Inter-individual variability may be a concern
Specialised laboratory analysis may be required
Reproducibility could be a concern
May not be cost-effective