title: Point-of-Care HbA1c Testing with the A1cNow Test Kit in General Practice Dental Clinics: A Pilot Study Involving Its Accuracy and Practical Issues in Its Use.
abstract: With millions of at-risk people undiagnosed with pre-diabetes and diabetes, there is a need to identify alternate screening sites for out-of-range glucose values. We examined practical issues and accuracy (relative to High Performance Liquid Chromatography testing in a laboratory) in the use of the A1cNow point of care device for this screening in general practice dental clinics at a large University-based Dental College. Health care professionals obtained evaluable readings for only 70% of the subjects, even after two attempts, and its use according to manufacturer's instructions was often challenging in the busy environment of the dental clinic. At thresholds for pre-diabetes and diabetes established by the American Diabetes Association, sensitivities of the A1cNow kit relative to the HPLC method were 91.9% and 100%, respectively. However, specificities for pre-diabetes and diabetes were 66.7% and 82.4%, respectively, indicating many false positive results. A better strategy for diabetes screening may involve a laboratory-based analysis approach that is patient- and provider-friendly, with minimal burden to the dental team.
authors.affiliation: College of Nursing, New York University, New York, New York, USA.
authors.forename: Shiela M
authors.initials: SM
authors.lastname: Strauss
authors.affiliation: College of Nursing, New York University, New York, New York, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Rosedale
authors.affiliation: Center for Advanced Laboratory Medicine, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pesce
authors.affiliation: New York University Langone Medical Center, New York, New York, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Juterbock
authors.affiliation: College of Nursing, New York University, New York, New York, USA.
authors.forename: Navjot
authors.initials: N
authors.lastname: Kaur
authors.affiliation: College of Nursing, New York University, New York, New York, USA.
authors.forename: Joe
authors.initials: J
authors.lastname: DePaola
authors.affiliation: New York University Langone Medical Center, New York, New York, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Goetz
authors.affiliation: College of Dentistry, New York University, New York, New York, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Wolff
authors.affiliation: New York University Langone Medical Center, New York, New York, USA.
authors.forename: Dolores
authors.initials: D
authors.lastname: Malaspina
authors.affiliation: New York University Langone Medical Center, New York, New York, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Danoff
keywords: A1c; dental visit; diabetes screening; point of care