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Multicenter Study
. 2024 Jun 6;14(6):e083121.
doi: 10.1136/bmjopen-2023-083121.

External validation of three diabetes prediction scores in a Spanish cohort: does adding high risk for depression improve the validation of the FINDRISC score (FINDRISC-MOOD)?

Miguel Salinero-Fort  1   2 , Jose M Mostaza-Prieto  3 , Carlos Lahoz-Rallo  3 , Juan Cárdenas-Valladolid  4   5 , Victor Iriarte-Campo  6 , Eva Estirado-Decabo  3 , Francisca Garcia-Iglesias  3 , Teresa Gonzalez-Alegre  3 , Belen Fernandez-Puntero  7 , Victor M Cornejo-Del Rio  8 , Vanesa Sanchez-Arroyo  3 , Concesa Sabín-Rodríguez  9 , Silvia López-López  9 , Paloma Gómez-Campelo  10 , Belen Taulero-Escalera  11 , Fernando Rodriguez-Artalejo  12   13   14 , Francisco Javier San Andrés-Rebollo  15 , Carmen De Burgos-Lunar  16 ; SPREDIA-2 Group
Collaborators, Affiliations
Multicenter Study

External validation of three diabetes prediction scores in a Spanish cohort: does adding high risk for depression improve the validation of the FINDRISC score (FINDRISC-MOOD)?

Miguel Salinero-Fort et al. BMJ Open. .

Abstract

Objectives: To evaluate the external validity of the FINDRISC, DESIR and ADA risk scores for the prediction of diabetes in a Spanish population aged >45 years and to test the possible improvement of FINDRISC by adding a new variable of high risk of depression when Patient Health Questionnaire-9 (PHQ-9) questionnaire score ≥10 (FINDRISC-MOOD).

Design: Prospective population-based cohort study.

Setting: 10 primary healthcare centres in the north of the city of Madrid (Spain).

Participants: A total of 1242 participants without a history of diabetes and with 2-hour oral glucose tolerance test (OGTT) plasma glucose <200 mg/dL (<11.1 mmol/L) were followed up for 7.3 years (median) using their electronic health records (EHRs) and telephone contact.

Primary and secondary outcome measures: Diabetes risk scores (FINDRISC, DESIR, ADA), PHQ-9 questionnaire and 2-hour-OGTT were measured at baseline. Incident diabetes was defined as treatment for diabetes, fasting plasma glucose ≥126 mg/dL (≥7.0 mmol/L), new EHR diagnosis or self-reported diagnosis. External validation was performed according to optimal cut-off, sensitivity, specificity and Youden Index. Comparison between diabetes risk scores, including FINDRISC-MOOD (original FINDRISC score plus five points if PHQ-9 ≥10), was measured by area under the receiver operating characteristic curve (AUROC).

Results: During follow-up, 104 (8.4%; 95% CI, 6.8 to 9.9) participants developed diabetes and 185 had a PHQ-9 score ≥10. The AUROC values were 0.70 (95% CI, 0.67 to 0.72) for FINDRISC-MOOD and 0.68 (95% CI, 0.65 to 0.71) for the original FINDRISC. The AUROCs for DESIR and ADA were 0.66 (95% CI, 0.63 to 0.68) and 0.66 (95% CI, 0.63 to 0.69), respectively. There were no significant differences in AUROC between FINDRISC-MOOD and the other scores.

Conclusions: The results of FINDRISC-MOOD were like those of the other risk scores and do not allow it to be recommended for clinical use.

Keywords: General diabetes; Risk Factors; Surveys and Questionnaires.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of people included in the study. DM, diabetes mellitus; OGTT, oral glucose tolerance test; PHQ-9, Patient Health Questionnaire-9.
See this image and copyright information in PMC

References

    1. Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care 2003;26:725–31. 10.2337/diacare.26.3.725 - DOI - PubMed
    1. Balkau B, Lange C, Fezeu L, et al. . Predicting diabetes: clinical, biological, and genetic approaches. Diabetes Care 2008;31:2056–61. 10.2337/dc08-0368 - DOI - PMC - PubMed
    1. American Diabetes Association . Classification and diagnosis of diabetes: standards of medical care in diabetes-2020 . Diabetes Care 2020;43:S14–31. 10.2337/dc20-S002 - DOI - PubMed
    1. Bernabe-Ortiz A, Perel P, Miranda JJ, et al. . Diagnostic accuracy of the Finnish diabetes risk score (FINDRISC) for Undiagnosed T2Dm in Peruvian population. Prim Care Diabetes 2018;12:517–25. 10.1016/j.pcd.2018.07.015 - DOI - PMC - PubMed
    1. Bergmann A, Li J, Wang L, et al. . A simplified Finnish diabetes risk score to predict type 2 diabetes risk and disease evolution in a German population. Horm Metab Res 2007;39:677–82. 10.1055/s-2007-985353 - DOI - PubMed

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