Herman W H, Smith P J, Thompson T J, Engelgau M M, Aubert R E
Epidemiology and Statistics Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA
Diabetes Care. 1995 Mar;18(3):382-7. doi: 10.2337/diacare.18.3.382.
To develop a simple questionnaire to prospectively identify individuals at increased risk for undiagnosed diabetes.
People with newly diagnosed diabetes (n = 164) identified in the Second National Health and Nutrition Examination Survey and those with neither newly diagnosed diabetes nor a history of physician-diagnosed diabetes (n = 3,220) were studied. Major historical risk factors for undiagnosed non-insulin-dependent diabetes were defined, and classification trees were developed to identify people at higher risk for previously undiagnosed diabetes. The sensitivity, specificity, and predictive value of the classification trees were described and compared with those of an existing questionnaire.
The selected classification tree incorporated age, sex, history of delivery of a macrosomic infant, obesity, sedentary lifestyle, and family history of diabetes. In a representative sample of the U.S. population, the sensitivity of the tree was 79%, the specificity was 65%, and the predictive value positive was 10%.
This classification tree performed significantly better than an existing questionnaire and should serve as a simple, noninvasive, and potentially cost-effective tool for diagnosing diabetes in the U.S.
开发一种简单的问卷,用于前瞻性地识别未诊断糖尿病风险增加的个体。
对在第二次全国健康与营养检查调查中确诊的新发糖尿病患者(n = 164)以及既无新发糖尿病也无医生诊断糖尿病病史的个体(n = 3220)进行研究。确定未诊断的非胰岛素依赖型糖尿病的主要历史风险因素,并构建分类树以识别先前未诊断糖尿病风险较高的人群。描述了分类树的敏感性、特异性和预测价值,并与现有问卷的结果进行比较。
所选分类树纳入了年龄、性别、巨大儿分娩史、肥胖、久坐生活方式和糖尿病家族史。在美国人群的代表性样本中,该分类树的敏感性为79%,特异性为65%,阳性预测值为10%。
该分类树的表现明显优于现有问卷,应作为美国诊断糖尿病的一种简单、无创且可能具有成本效益的工具。