The performance of a risk score in predicting undiagnosed hyperglycemia.
OBJECTIVE
Type 2 diabetes is a serious disease that is commonly undetected and for which screening is sometimes advocated. A number of risk factors are associated with prevalent undiagnosed diabetes. The use of routinely available information on these factors has been proposed as a simple and effective way of identifying individuals at high risk for having the disease. The objective of this study was to assess the effectiveness of the Cambridge risk score in a large and representative population.


METHODS
A risk score derived from data in a previous study was tested for its ability to detect prevalent undiagnosed hyperglycemia as measured by a GHb > or = 6.0, 6.5, or 7% in 6,567 subjects aged 39-78 years in the European Prospective Investigation of Cancer-Norfolk cohort.


RESULTS
For a specificity of 78%, the risk score predicted a GHb of > or = 7.0% in subjects aged 39-78 years, with a sensitivity of 51% (95% CI 40-62). The areas under the receiver-operating characteristic (ROC) curve for GHb > or = 6.0, 6.5, and 7% were 65.7% (63.8-67.6), 71.2% (68.4-75.2), and 74.2% (69.5-79.0), respectively. The area under the ROC curve was not significantly reduced if data on family and smoking history were unavailable for any of the cut-offs for GHb.


CONCLUSIONS
The risk score performed as well as other previously reported models in all age groups. We concluded that a simple risk score using data routinely available in primary care can identify people with an elevated GHb with reasonable sensitivity and specificity, and it could therefore form part of a strategy for early detection of type 2 diabetes.
Park
P J
PJ
Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK.
Griffin
S J
SJ
Sargeant
L
L
Wareham
N J
NJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000235:genetics; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology*; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012044:Regression Analysis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012727:Sex Characteristics
D001786:Blood Glucose