Appendix FKey Question 1 – HSROC Curves

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Hierarchical summary receiver-operator curves (HSROC) with the 95 percent confidence ellipse are shown below for two different comparisons. The summary graphic compares the sensitivity and specificity for all studies comparing a particular screening test with GDM diagnostic criteria. All points are clustered in the upper left hand quadrant and there is no overalp between the 95 percent confidence ellipse and the diagonal null line. This indicates that the ability of the screening test to correctly classify patients with GDM is significantly better than random classification.

Figure F-1 depicts the HSROC curve of the 50 g OGCT screening test vs. ADA (2000-2010) or Carpenter-Coustan diagnostic criteria, by two different OGCT thresholds of ≥130 mg/dL and ≥140 mg/dL. The HSROC curve incorporates all study results with the 95 percent confidence ellipse, with two HSROC curves shown, one for each threshold. This figure is described in the main report under Carpenter and Coustan and ADA (2000-2010) Criteria, Results as follows: “The summary graphic compares the sensitivity and specificity for all studies and presents separate curves for the two different cutoff values used in the OGCT (i.e., ≥140 mg/dL and ≥130 mg/dL). All points are clustered in the upper left hand quadrant and there is no overlap between the 95 percent confidence ellipse and the diagonal null line. This indicates that the ability of the test to correctly classify patients with GDM is significantly better than random classification. The studies using the ≥130 mg/dL cutoff value demonstrate higher sensitivity but lower specificity than studies using the ≥140mg/dL cutoff value.”

Figure F-1HSROC curve: 50 g OGCT (≥140 mg/dL and ≥130 mg/dL ) by Carpenter-Coustan criteria

Figure F-2 depicts the HSROC curve of the eight studies that provided data to estimate sensitivity and specificity of a 50 g OGCT tested at the 1-hour interval and cutoff value of ≥140mg/dL. The HSROC curve with the 95 percent confidence ellipse compares the sensitivity and specificity for all studies that used a cutoff value of ≥ 140 mg/dL in the OGCT. This figure is described in the main report under NDDG Criteria, Results as follows: “All points are clustered in the upper left hand quadrant and there is no overlap between the 95 percent confidence ellipse and the diagonal null line.”

Figure F-2HSROC curve: 50 g OGCT (≥ 140 mg/dL) by NDDG criteria