Validation of the Diabetes Risk Assessment in Dentistry Score in NHANES 2009-2014

Area of Science:

• Public Health
• Epidemiology
• Dental Public Health

Background:

• Type 2 diabetes mellitus (T2DM) is a growing public health concern with significant oral health implications.
• Early identification and risk stratification are crucial for effective T2DM prevention and management.
• Dental professionals are well-positioned to play a role in diabetes screening.

Purpose of the Study:

• To validate the Diabetes Risk Assessment in Dentistry Score (DDS) in a US population-based sample.
• To compare the performance of the DDS with the American Diabetes Association (ADA) risk calculator and the Leicester Risk Assessment (LRA).

Main Methods:

• Utilized data from the National Health and Nutrition Examination Survey (NHANES) 2009-2014 cycles.
• Included participants aged 40 years and older with complete data for DDS and ADA risk score assessment.
• Evaluated model performance using the area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA).

Main Results:

• The DDS demonstrated an AUC of 0.64, marginally outperforming the ADA risk calculator (AUC=0.61) and LRA (AUC=0.631).
• Decision curve analysis indicated that the DDS has added clinical value in decision-making across most probability thresholds.
• The study included 6259 participants aged 40-80 years, with 50.8% females.

Conclusions:

• The DDS shows acceptable discriminative ability for identifying diabetes risk in American adults aged 40 years and older.
• The DDS exhibited marginally superior performance compared to the ADA risk calculator and LRA.
• The findings support the potential utility of the DDS as a complementary screening tool within dental practice settings.