title: The Evaluation of Screening and Early Detection Strategies for Type 2 Diabetes and Impaired Glucose Tolerance (DETECT-2) update of the Finnish diabetes risk score for prediction of incident type 2 diabetes.
abstract: OBJECTIVE
  The Finnish diabetes risk questionnaire is a widely used, simple tool for identification of those at risk for drug-treated type 2 diabetes. We updated the risk questionnaire by using clinically diagnosed and screen-detected type 2 diabetes instead of drug-treated diabetes as an endpoint and by considering additional predictors.
  
  
  METHODS
  Data from 18,301 participants in studies of the Evaluation of Screening and Early Detection Strategies for Type 2 Diabetes and Impaired Glucose Tolerance (DETECT-2) project with baseline and follow-up information on oral glucose tolerance status were included. Incidence of type 2 diabetes within 5 years was used as the outcome variable. Improvement in discrimination and classification of the logistic regression model was assessed by the area under the receiver-operating characteristic (ROC) curve and by the net reclassification improvement. Internal validation was by bootstrapping techniques.
  
  
  RESULTS
  Of the 18,301 participants, 844 developed type 2 diabetes in a period of 5 years (4.6%). The Finnish risk score had an area under the ROC curve of 0.742 (95% CI 0.726-0.758). Re-estimation of the regression coefficients improved the area under the ROC curve to 0.766 (95% CI 0.750-0.783). Additional items such as male sex, smoking and family history of diabetes (parent, sibling or both) improved the area under the ROC curve and net reclassification. Bootstrapping showed good internal validity.
  
  
  CONCLUSIONS
  The predictive value of the original Finnish risk questionnaire could be improved by adding information on sex, smoking and family history of diabetes. The DETECT-2 update of the Finnish diabetes risk questionnaire is an adequate and robust predictor for future screen-detected and clinically diagnosed type 2 diabetes in Europid populations.
authors.affiliation: Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands. m.alssema@vumc.nl
authors.forename: M
authors.initials: M
authors.lastname: Alssema
authors.forename: D
authors.initials: D
authors.lastname: Vistisen
authors.forename: M W
authors.initials: MW
authors.lastname: Heymans
authors.forename: G
authors.initials: G
authors.lastname: Nijpels
authors.forename: C
authors.initials: C
authors.lastname: Glümer
authors.forename: P Z
authors.initials: PZ
authors.lastname: Zimmet
authors.forename: J E
authors.initials: JE
authors.lastname: Shaw
authors.forename: M
authors.initials: M
authors.lastname: Eliasson
authors.forename: C D A
authors.initials: CD
authors.lastname: Stehouwer
authors.forename: A G
authors.initials: AG
authors.lastname: Tabák
authors.forename: S
authors.initials: S
authors.lastname: Colagiuri
authors.forename: K
authors.initials: K
authors.lastname: Borch-Johnsen
authors.forename: J M
authors.initials: JM
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D018149:Glucose Intolerance / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires