The Performance of a Risk Score in Predicting Undiagnosed Hyperglycemia
- P.J. Park, MPHIL,
- S.J. Griffin, DM, MRCGP,
- L. Sargeant, DM and
- N. J. Wareham, MB, PHD
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, U.K.
Abstract
OBJECTIVE—Type 2 diabetes is a serious disease that is commonly undetected and for which screening is sometimes advocated. A number of risk factors are associated with prevalent undiagnosed diabetes. The use of routinely available information on these factors has been proposed as a simple and effective way of identifying individuals at high risk for having the disease. The objective of this study was to assess the effectiveness of the Cambridge risk score in a large and representative population.
RESEARCH DESIGN AND METHODS—A risk score derived from data in a previous study was tested for its ability to detect prevalent undiagnosed hyperglycemia as measured by a GHb ≥6.0, 6.5, or 7% in 6,567 subjects aged 39–78 years in the European Prospective Investigation of Cancer−Norfolk cohort.
RESULTS—For a specificity of 78%, the risk score predicted a GHb of ≥7.0% in subjects aged 39–78 years, with a sensitivity of 51% (95% CI 40–62). The areas under the receiver-operating characteristic (ROC) curve for GHb ≥6.0, 6.5, and 7% were 65.7% (63.8–67.6), 71.2% (68.4–75.2), and 74.2% (69.5–79.0), respectively. The area under the ROC curve was not significantly reduced if data on family and smoking history were unavailable for any of the cut-offs for GHb.
CONCLUSIONS—The risk score performed as well as other previously reported models in all age groups. We concluded that a simple risk score using data routinely available in primary care can identify people with an elevated GHb with reasonable sensitivity and specificity, and it could therefore form part of a strategy for early detection of type 2 diabetes.
- AUC, area under the curve
- EPIC, European Prospective Investigation of Cancer
- PM, prediction model
- ROC, receiver-operating characteristic
Footnotes
-
Address correspondence and reprint requests to Dr. Nicholas J. Wareham, Department of Public Health and Primary Care, University of Cambridge, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, U.K. E-mail: njw1004{at}medschl.cam.ac.uk.
Received for publication 13 September 2001 and accepted in revised form 13 March 2002.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
- DIABETES CARE
