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Prev Chronic Dis. 2010 Mar;7(2):A34. Epub 2010 Feb 15.

A new public health tool for risk assessment of abnormal glucose levels.

Author information

1
California Diabetes Program, P.O. Box 997377, MS 7211, Sacramento, CA 95899-7377, USA. Gary.He@cdph.ca.gov

Abstract

INTRODUCTION:

Self-reported prediabetes and diabetes rates underestimate true prevalence, but mass laboratory screening is generally impractical for risk assessment and surveillance. We developed the Abnormal Glucose Risk Assessment-6 (AGRA-6) tool to address this problem.

METHODS:

Self-report data were obtained from the 1,887 adults (18 years or older) in the National Health and Nutrition Examination Survey (NHANES) 2005-2006 with fasting plasma glucose and oral glucose tolerance tests. We created AGRA-6 models by using logistic regression. Performance was validated with NHANES 2005-2006 data by using leave-1-out cross-validation. Standard performance characteristics (sensitivity, specificity, predictive values, area under receiver-operating characteristic curves) were assessed, as was the potential efficiency of the models to reduce laboratory testing in screening efforts.

RESULTS:

Performance was good for all models under testing conditions. Use of the AGRA-6 in screening efforts could reduce laboratory testing by at least 30% when sensitivity is maximized and at least 52% when sensitivity and specificity are balanced.

CONCLUSION:

The AGRA-6 appears to be an effective, feasible tool that uses self-reported data compatible with the Behavioral Risk Factor Surveillance System to assess population-level prevalence, identify abnormal glucose levels, optimize screening efforts, and focus interventions to reduce the prevalence of abnormal glucose levels.

PMID:
20158962
PMCID:
PMC2831788
[Indexed for MEDLINE]
Free PMC Article
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