Development of a Type 2 Diabetes Risk Model From a Panel of Serum Biomarkers From the Inter99 Cohort
Response to Rathmann, Kowall, and Schulze
- Robert W. Gerwien, PHD,
- Michael W. Rowe, PHD,
- Edward Moler, PHD,
- Mickey S. Urdea, PHD,
- Michael P. McKenna, PHD and
- Janice A. Kolberg, PHD
- From Tethys Bioscience, Emeryville, California.
- Corresponding author: Janice A. Kolberg, jkolberg{at}tethysbio.com.
Rathmann, Kowall, and Schulze (1) suggest that the diabetes risk score (DRS) model is no better than simple clinical models and thus is of limited utility. To support this contention, they compare our area under the receiver operating characteristic curve (AROC) with those reported for different models. However, the AROC of a test is population specific; therefore, comparisons between populations with different baseline risks are problematic because sensitivity and specificity are subject to alteration by disease prevalence (2). In general, the AROC decreases as prevalence increases as it is increasingly difficult to differentiate outcomes in less healthy populations. The Inter99 subpopulation with age >39 years and BMI ≥25 kg/m2 that we used had a 5-year risk of 5.7%, nearly 2.5-fold higher …
