Diabetes Risk Calculator: a simple tool for detecting undiagnosed diabetes and pre-diabetes.
OBJECTIVE
The objective of this study was to develop a simple tool for the U.S. population to calculate the probability that an individual has either undiagnosed diabetes or pre-diabetes.


METHODS
We used data from the Third National Health and Nutrition Examination Survey (NHANES) and two methods (logistic regression and classification tree analysis) to build two models. We selected the classification tree model on the basis of its equivalent accuracy but greater ease of use.


RESULTS
The resulting tool, called the Diabetes Risk Calculator, includes questions on age, waist circumference, gestational diabetes, height, race/ethnicity, hypertension, family history, and exercise. Each terminal node specifies an individual's probability of pre-diabetes or of undiagnosed diabetes. Terminal nodes can also be used categorically to designate an individual as having a high risk for 1) undiagnosed diabetes or pre-diabetes, 2) pre-diabetes, or 3) neither undiagnosed diabetes or pre-diabetes. With these classifications, the sensitivity, specificity, positive and negative predictive values, and receiver operating characteristic area for detecting undiagnosed diabetes are 88%, 75%, 14%, 99.3%, and 0.85, respectively. For pre-diabetes or undiagnosed diabetes, the results are 75%, 65%, 49%, 85%, and 0.75, respectively. We validated the tool using v-fold cross-validation and performed an independent validation against NHANES 1999-2004 data.


CONCLUSIONS
The Diabetes Risk Calculator is the only currently available noninvasive screening tool designed and validated to detect both pre-diabetes and undiagnosed diabetes in the U.S. population.
Heikes
Kenneth E
KE
Archimedes, San Francisco, California, USA.
Eddy
David M
DM
Arondekar
Bhakti
B
Schlessinger
Leonard
L
D003920:Diabetes Mellitus / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006306:Health Surveys; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009749:Nutrition Surveys; D011236:Prediabetic State / Q000453:epidemiology*; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors