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Test agreement for classifying diabetes in indigenous Australians
Mark Daniel1, Kevin G Rowley, Elisabeth Marks
1Département de Médecine Sociale et Préventive, Université de Montréal, Canada. mark.daniel@umontreal.ca
Australian and New Zealand Journal of Public Health
|May 10, 2006
Summary
Fasting plasma glucose (FPG) testing is a reliable diabetes screening method for remote Indigenous Australians. Agreement with the oral glucose tolerance test (OGTT) was significantly higher than in non-Indigenous populations.
Area of Science:
- Medical research
- Public health
- Diabetes diagnostics
Background:
- Diabetes screening is crucial for Indigenous Australians.
- The oral glucose tolerance test (OGTT) is a standard diagnostic method.
- Fasting plasma glucose (FPG) is a simpler screening alternative.
Purpose of the Study:
- To assess the agreement between FPG and OGTT for diabetes diagnosis in Indigenous Australians.
- To compare this agreement with findings from non-Indigenous populations.
- To evaluate the reliability of FPG as a screening tool in remote settings.
Main Methods:
- Screening conducted in 25 remote Australian settlements.
- Agreement evaluated using the kappa coefficient (chance-corrected agreement).
- Data collected from 3,249 participants aged 15-94 years.
Main Results:
- Kappa values for agreement ranged from 0.70-0.77 across different diabetes prevalence rates (5-30%).
- Overall agreement between FPG and OGTT was 0.76.
- Agreement in this Indigenous Australian cohort was substantially higher than reported in non-Indigenous samples (kappa 0.21-0.48).
Conclusions:
- FPG testing with a 7.0 mmol/L cut-off is a reliable diabetes screening method for remote Indigenous communities.
- The superior agreement highlights the FPG test's effectiveness in this specific population.
- Findings support the use of FPG as a practical screening tool in resource-limited remote areas.