Screening for diabetes: sensitivity and positive predictive value of risk factor total.
OBJECTIVE
Screening for diabetes is recommended for individuals > or =45 years of age, or earlier if they manifest > or = one specific risk factors. This study examined the sensitivity and positive predictive value (PPV) of risk factor total for identifying individuals with diabetes and prediabetes.


METHODS
Subjects were interviewed to assess the presence of risk factors. Fasting plasma glucose levels were obtained.


METHODS
The study occurred at a health fair in Greensburg, PA.


METHODS
Six hundred sixty-one Caucasians between the ages of 19 and 100.


RESULTS
Using the criterion of screening individuals with > or = one risk factors detected 100% of both diabetics and prediabetics. This dropped to 91.2% when screening individuals with > or = two factors. The PPV of the risk factor total was poor (80% of individuals with a total of four factors were not diabetic). The ability of the risk factor total to predict individuals with impaired glucose metabolism (prediabetics + diabetics) was considerably better, and increased almost linearly with the risk factor total. Of the subjects with normal glucose values, the mean glucose increased as the risk factor total increased.


CONCLUSIONS
While the sensitivity of using > one risk factor as an algorithm to screen is 100% for identifying diabetics, the PPV of risk factor analysis for identifying diabetics is poor. The same algorithm works well to identify at-risk individuals, presumably allowing early intervention and education.
Behan
Kristina Jackson
KJ
Medical Technology Program, Department of Biology, Division of Life and Health Sciences, Building 58, University of West Florida, 11000 University Parkway, Pensacola, FL 32514, USA. kbehan@uwf.edu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis*; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity
D001786:Blood Glucose