期刊
EPIDEMIOLOGIC REVIEWS
卷 33, 期 1, 页码 46-62出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/epirev/mxq019
关键词
diabetes mellitus; type 2; predictive value of tests; risk assessment; ROC curve; sensitivity and specificity
资金
- European Union [LSHM-CT-2006-037197]
- NIHR [RP-PG-0606-1259]
- MRC [MC_U106179474] Funding Source: UKRI
- Medical Research Council [MC_U106179474] Funding Source: researchfish
- National Institute for Health Research [RP-PG-0606-1259] Funding Source: researchfish
Trials have demonstrated the preventability of type 2 diabetes through lifestyle modifications or drugs in people with impaired glucose tolerance. However, alternative ways of identifying people at risk of developing diabetes are required. Multivariate risk scores have been developed for this purpose. This article examines the evidence for performance of diabetes risk scores in adults by 1) systematically reviewing the literature on available scores and 2) their validation in external populations; and 3) exploring methodological issues surrounding the development, validation, and comparison of risk scores. Risk scores show overall good discriminatory ability in populations for whom they were developed. However, discriminatory performance is more heterogeneous and generally weaker in external populations, which suggests that risk scores may need to be validated within the population in which they are intended to be used. Whether risk scores enable accurate estimation of absolute risk remains unknown; thus, care is needed when using scores to communicate absolute diabetes risk to individuals. Several risk scores predict diabetes risk based on routine noninvasive measures or on data from questionnaires. Biochemical measures, in particular fasting plasma glucose, can improve prediction of such models. On the other hand, usefulness of genetic profiling currently appears limited.
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