External validation of Prediabetes Risk Test in Indian population for screening prediabetes
Radhika Aditya Jadhav1, G Arun Maiya2, Shashikiran Umakanth3
1PhD Scholar, Centre for Diabetic Foot Care & Research (Physiotherapy), Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Insights
The Prediabetes Risk Test (PRT) shows low sensitivity (48.1%) for identifying prediabetes in Indians, but high specificity (95.5%) for ruling it out. Further research is needed to adapt the PRT for the Indian population.
Area of Science:
- Endocrinology
- Public Health
- Epidemiology
Background:
- The Prediabetes Risk Test (PRT) is validated for Western populations.
- Ethnic and biological factors influence prediabetes development.
- Limited data exists on PRT's validity in the Indian population.
Purpose of the Study:
- To assess the external validity of the PRT for prediabetes screening in India.
- To determine the effectiveness of PRT in an Indian demographic.
Main Methods:
- 522 Indian participants (18-60 years) were studied.
- Data collected included medical history, physical activity, and anthropometrics.
- Prediabetes diagnosis used fasting blood sugar and HbA1c; PRT validation involved sensitivity, specificity, PPV, NPV, and likelihood ratios.
- Receiver operating characteristic (ROC) curve analysis identified optimal PRT cut-off for Indians.
Main Results:
- PRT sensitivity was 48.1%, specificity 95.5%, positive predictive value 66.1%, and negative predictive value 90.9% in the Indian cohort.
- ROC analysis suggested an optimal PRT cut-off of approximately 3 for Indians.
Conclusions:
- PRT demonstrates low sensitivity, potentially limiting its utility for identifying true prediabetes cases in India.
- High specificity suggests PRT may be effective in identifying individuals without prediabetes.
- Modification of the PRT is recommended for improved accuracy and applicability within the Indian population.
Background:
Prediabetes Risk Test (PRT) has been found valid in the Western population for screening prediabetes. However, ethnicity, race, geographical and other biological characteristics have been linked to the development of prediabetes. There is a dearth of literature on the external validity of PRT in the Indian population. So, the objective of this study was to assess the external validity of the PRT in the Indian population for screening prediabetes.
Methods:
The study contained 522 participants aged between 18 and 60 years. The medical history, physical activity level and anthropometric measures were assessed. Prediabetes was diagnosed using fasting blood sugar and HbA1C levels. External validation of PRT was performed using specificity, sensitivity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio. The receiver operating curve was plotted to identify the optimum cut-off value for Indians.
Results:
The study found that the sensitivity of PRT was 48.1%, specificity 95.5%, positive predictive value 66.1% and negative predictive value 90.9% for screening prediabetes in the Indian population. Receiver operating curve analysis revealed that the optimum cut-off of PRT was around 3 for Indians.
Conclusion:
The results showed that PRT might not be useful in the Indian population to identify the true positives of prediabetes as it has a sensitivity of 48.1%. However, it can be helpful to identify the true negatives as the specificity is 95.5%. Further study is required to modify PRT for the Indian context to make it more appropriate for the Indian population.
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