Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, USA.
Graduate School of Psychology, Yeshiva University, USA; Medicine (Endocrinology) and Epidemiology & Population Health, Albert Einstein College of Medicine, USA.
Diabetes Res Clin Pract. 2018 Aug;142:120-129. doi: 10.1016/j.diabres.2018.05.009. Epub 2018 May 28.
Undiagnosed diabetes is more prevalent among racial/ethnic minorities in the United States (U.S.). Despite the proliferation of risk scores, few have been validated in Hispanics populations. The aim of this study is to systematically review published studies that developed risk scores to identify undiagnosed Type 2 Diabetes Mellitus based on self-reported information that were validated for Hispanics in the U.S.
The search included PubMed, EMBASE, Cochrane and CINAHL from inception to 2016 without language restrictions. Risk scores whose main outcome was undiagnosed Type 2 diabetes reporting performance measures for Hispanics were included.
We identified three studies that developed and validated risk scores for undiagnosed diabetes based on questionnaire data. Two studies were conducted in Latin America and one in the U.S. All three studies reported adequate performance (area under the receiving curve (AUC) range between0.68and 0.78). The study conducted in the U.S. reported a higher sensitivity of their risk score for Hispanics than whites. The limited number of studies, small size and heterogeneity of the combined cohorts provide limited evidence of the validity of risk scores for Hispanics.
Efforts to develop and validate risk prediction models in Hispanic populations in the U.S are needed, particularly given the diversity of thisfast growing population. Healthcare professionals should be aware of the limitations of applying risk scores developed for the general population on Hispanics.
在美国,未被诊断的糖尿病在少数族裔/族裔群体中更为普遍。尽管风险评分大量涌现,但很少有针对西班牙裔人群进行验证。本研究旨在系统地回顾已发表的研究,这些研究基于自我报告的信息开发了用于识别未被诊断的 2 型糖尿病的风险评分,并在美国的西班牙裔人群中进行了验证。
从开始到 2016 年,搜索包括 PubMed、EMBASE、Cochrane 和 CINAHL,不限制语言。纳入的风险评分主要结局为未被诊断的 2 型糖尿病,报告了针对西班牙裔人群的表现衡量指标。
我们确定了三项基于问卷调查数据开发和验证未被诊断的糖尿病风险评分的研究。两项研究在拉丁美洲进行,一项在美国进行。这三项研究均报告了足够的性能(接收曲线下面积(AUC)范围在 0.68 至 0.78 之间)。在美国进行的研究报告称,其风险评分对西班牙裔人群的敏感性高于白人。由于综合队列的研究数量有限、规模小且存在异质性,因此仅提供了风险评分对西班牙裔人群有效性的有限证据。
需要在美国的西班牙裔人群中努力开发和验证风险预测模型,特别是考虑到这个快速增长的人群的多样性。医疗保健专业人员应该意识到将为一般人群开发的风险评分应用于西班牙裔人群的局限性。