title: Screening blood donors for diabetes: analysis of use, accuracy, and cost.
abstract: BACKGROUND
  The objective was to determine if a free, voluntary diabetes screening program as a part of the blood donation process might be cost-effective.
  
  
  METHODS
  During the first 6 months of the program, 26,415 donors were screened using a single random plasma glucose (RPG) level. All donors were asked to eat before donation. Low-, moderate-, and high-risk groups were formed based on RPG levels (<140, 140-200, and >200 mg/dL). Contact with a telephone questionnaire was made with 139 of 178 (78%) of the persons in the high-risk group with 33 new cases of diabetes diagnosed by the donor's physician and 26 donors indicating that they were not diagnosed with diabetes. Sex- and age-matched donors in the low- and moderate-risk groups were contacted and administered the same questionnaire.
  
  
  RESULTS
  The three risk groups were similar, except for body mass index (28.1 ± 5.4 kg/m2 vs. 29.9 ± 5.5 kg/m2 vs. 32.7 ± 5.6 kg/m2 , p < 0.001). The discriminative effectiveness of screening was evaluated by the area under the receiver operating characteristics (AROC) curve. The AROC curve was 0.950 (95% confidence interval, 0.920-0.979) for the identification of diabetes. Using a RPG cutoff of 200 mg/dL, sensitivity was 100%, specificity was 82%, and positive predictive value was 56%. Cost analyses showed that the mean cost to screen, per donor, was less than $1. Cost per case identified was estimated to be less than $500 for a RPG cutoff of 200 mg/dL.
  
  
  CONCLUSIONS
  Screening during the blood donation process appears to be accurate, convenient, and inexpensive.
authors: Diabetes and Metabolic Research Center, Christiana Care Health System (CCHS), Newark, Delaware; Diabetes and Metabolic Diseases Center (CCHS), the Department of Medical Laboratory Sciences, University of Delaware, Newark, Delaware; Blood Bank of Delmarva, Newark, Delaware; Christiana Care Outcomes Research, Newark, Delaware.
authors: M James
authors: MJ
authors: Lenhard
authors: Raelene E
authors: RE
authors: Maser
authors: Paul
authors: P
authors: Kolm
authors: Michael J
authors: MJ
authors: Healy
authors: Prakash
authors: P
authors: Seshadri
mesh_terms: D000368:Aged; D001771:Blood Banks; D001782:Blood Donors; D001786:Blood Glucose / Q000032:analysis*; D003365:Costs and Cost Analysis; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve
chemical_list: D001786:Blood Glucose