Subject    :    [2017 Oct;41(5)] Performance of the Achutha Menon Centre Diabetes Risk Score in Identifying Prevalent Diabetes in Tamil Nadu, India
Writer KDA
Date 2018-12-03 18:29:06 Hit 1,300
Diabetes Metab J. 2017 Oct;41(5):386-392. English.
Published online Aug 25, 2017.  https://doi.org/10.4093/dmj.2017.41.5.386 
Copyright © 2017 Korean Diabetes Association
   
Performance of the Achutha Menon Centre Diabetes Risk Score in Identifying Prevalent Diabetes in Tamil Nadu, India
Anu Mary Oommen,1 Vinod Joseph Abraham,1 Thirunavukkarasu Sathish,2 V. Jacob Jose,3 and Kuryan George1
1Department of Community Health, Christian Medical College, Vellore, India.
2Centre for Population Health Sciences, Nanyang Technological University, Singapore, Singapore.
3Department of Cardiology, Christian Medical College, Vellore, India.

Corresponding author: Anu Mary Oommen. Department of Community Health, Christian Medical College, IDA Scudder Rd, Vellore 632002, India. Email: anuoommen@cmcvellore.ac.in 
 
Received January 11, 2017; Accepted April 06, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract

Background

The Achutha Menon Centre Diabetes Risk Score (AMCDRS), which was developed in rural Kerala State, South India, had not previously been externally validated. We examined the performance of the AMCDRS in urban and rural areas in the district of Vellore in the South Indian state of Tamil Nadu, and compared it with other diabetes risk scores developed from India.

Methods

We used the data from 4,896 participants (30 to 64 years) of a cross-sectional study conducted in Vellore (2010 to 2012), to calculate the AMCDRS scores using age, family history, and waist circumference. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV), and the area under the receiver operating characteristic curve (AROC) were calculated for undiagnosed and total diabetes.

Results

Of the 4,896 individuals surveyed, 274 (5.6%) had undiagnosed diabetes and 759 (15.5%) had total diabetes. The AMCDRS, with an optimum cut-point of ≥4, identified 45.0% for further testing with 59.5% sensitivity, 60.5% specificity, 9.1% PPV, 95.8% NPV, and an AROC of 0.639 (95% confidence interval [CI], 0.608 to 0.670) for undiagnosed diabetes. The corresponding figures for total diabetes were 75.1%, 60.5%, 25.9%, 93.0%, and 0.731 (95% CI, 0.713 to 0.750), respectively. The AROC for the AMCDRS was not significantly different from that of the Indian Diabetes Risk Score, the Ramachandran or the Chaturvedi risk scores for total diabetes, but was significantly lower than the AROC of the Chaturvedi score for undiagnosed diabetes.

Conclusion

The AMCDRS is a simple diabetes risk score that can be used to screen for undiagnosed and total diabetes in low-resource primary care settings in India. However, it probably requires recalibration to improve its performance for undiagnosed diabetes.

   
Keywords:
DiabetesRisk scoreUndiagnosedUniversal screening

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