Scanlan Adam B, Maia Catarina M, Perez Alberly, Homko Carol J, O'Brien Matthew J
Center for Obesity Research and Education, Temple University College of Public Health, Philadelphia, PA.
Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
Diabetes Spectr. 2018 Feb;31(1):31-36. doi: 10.2337/ds16-0051.
Numerous validated questionnaires use self-reported data to quantify individuals' risk of having diabetes or developing it in the future. Evaluations of these tools have primarily used nationally representative data, limiting their application in clinical and community settings. This analysis tested the effectiveness of the American Diabetes Association (ADA) risk questionnaire for identifying prediabetes in a community-based sample of Latinas.
Data were collected using the ADA risk questionnaire and assessing A1C. Among 204 participants without diabetes, we examined the association between individual characteristics and glycemic status. We then calculated the performance characteristics (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) of the ADA risk questionnaire for detecting prediabetes, using A1C results as the gold standard to define the outcome.
All participants were women of self-reported Hispanic/Latino ethnicity. Their mean ADA risk score was 5.6 ± 1.6. Latinas who had prediabetes were older, with significantly higher rates of hypertension and a higher ADA risk score than those without prediabetes. At a risk score ≥5-the threshold for high risk set by the ADA-the questionnaire had the following test performance characteristics: sensitivity 77.8%, specificity 41.7%, PPV 76.2%, and NPV 43.9%.
The ADA risk questionnaire demonstrates reasonable performance for identifying prediabetes in a community-based sample of Latinas. Our data may guide other groups' use of this tool in the same target population. Future research should examine the effectiveness of this questionnaire for recruiting diverse populations into diabetes prevention programs. In addition, unique diabetes risk assessment tools for specific target populations are needed and may outperform questionnaires developed using nationally representative data.
众多经过验证的问卷使用自我报告数据来量化个体患糖尿病或未来患糖尿病的风险。对这些工具的评估主要使用具有全国代表性的数据，限制了它们在临床和社区环境中的应用。本分析测试了美国糖尿病协会（ADA）风险问卷在以社区为基础的拉丁裔样本中识别糖尿病前期的有效性。
使用ADA风险问卷收集数据并评估糖化血红蛋白（A1C）。在204名无糖尿病的参与者中，我们检查了个体特征与血糖状态之间的关联。然后，我们以A1C结果作为定义结果的金标准，计算ADA风险问卷检测糖尿病前期的性能特征（敏感性、特异性、阳性预测值[PPV]和阴性预测值[NPV]）。
所有参与者均为自我报告为西班牙裔/拉丁裔的女性。她们的平均ADA风险评分为5.6±1.6。患有糖尿病前期的拉丁裔女性年龄较大，高血压患病率显著更高，ADA风险评分也高于无糖尿病前期的女性。在风险评分≥5（ADA设定的高风险阈值）时，该问卷具有以下测试性能特征：敏感性77.8%，特异性41.7%，PPV 76.2%，NPV 43.9%。
ADA风险问卷在以社区为基础的拉丁裔样本中识别糖尿病前期表现出合理的性能。我们的数据可为其他群体在同一目标人群中使用该工具提供指导。未来的研究应检验该问卷在招募不同人群参与糖尿病预防项目方面的有效性。此外，需要针对特定目标人群的独特糖尿病风险评估工具，这些工具可能比使用全国代表性数据开发的问卷表现更好。
