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)?

Autor:	Salinero-Fort M; FIIBAP, Madrid, Spain miguel.salinero@salud.madrid.org.; Frailty, patterns of multimorbidity and mortality in the community-dwelling elderly population, IdiPAZ, Madrid, Spain., Mostaza-Prieto JM; Medicina Interna, Hospital Carlos III, Madrid, Spain., Lahoz-Rallo C; Medicina Interna, Hospital Carlos III, Madrid, Spain., Cárdenas-Valladolid J; Gerencia Asistencial de Atención Primaria, Comunidad de Madrid Servicio Madrileno de Salud, Madrid, Spain.; Enfermería, Universidad Alfonso X El Sabio, Villanueva de la Canada, Spain., Iriarte-Campo V; FIIBAP, Madrid, Spain., Estirado-Decabo E; Medicina Interna, Hospital Carlos III, Madrid, Spain., Garcia-Iglesias F; Medicina Interna, Hospital Carlos III, Madrid, Spain., Gonzalez-Alegre T; Medicina Interna, Hospital Carlos III, Madrid, Spain., Fernandez-Puntero B; Servicio de Bioquímica, Hospital Carlos III, Madrid, Spain., Cornejo-Del Rio VM; Supervisión de Enfermería, Hospital Carlos III, Madrid, Spain., Sanchez-Arroyo V; Medicina Interna, Hospital Carlos III, Madrid, Spain., Sabín-Rodríguez C; Unidad de Día, Hospital Carlos III, Madrid, Spain., López-López S; Unidad de Día, Hospital Carlos III, Madrid, Spain., Gómez-Campelo P; Fundación de Investigación, La Paz University Hospital Health Research Institute, Madrid, Spain., Taulero-Escalera B; Foundation for Research and Biomedical Innovation of Primary Care of the Community of Madrid (FIIBAP), Madrid, Spain., Rodriguez-Artalejo F; Department of Preventive Medicine and Public Health, Universidad Autonoma de Madrid, Madrid, Spain.; CIBERESP, Madrid, Spain.; IMDEA-Food, CEI UAM+CSIC, Madrid, Spain., San Andrés-Rebollo FJ; Centro de Salud Las Calesas, SERMAS, Madrid, Spain., De Burgos-Lunar C; Medicina Preventiva, Hospital Clinico San Carlos, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Jun 06; Vol. 14 (6), pp. e083121. Date of Electronic Publication: 2024 Jun 06.
DOI:	10.1136/bmjopen-2023-083121
Abstrakt:	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. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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