Diabetes Metab J.  2017 Oct;41(5):386-392. 10.4093/dmj.2017.41.5.386.

Performance of the Achutha Menon Centre Diabetes Risk Score in Identifying Prevalent Diabetes in Tamil Nadu, India

• Oommen AM
• Abraham VJ
• Sathish T
• Jose VJ
• George K

• KMID: 2392482
• DOI: http://doi.org/10.4093/dmj.2017.41.5.386

Abstract

BACKGROUND
The Achutha Menon Centre Diabetes Risk Score (AMCDRS), which was developed in rural Kerala State, South India, had not previously been externally validated. We examined the performance of the AMCDRS in urban and rural areas in the district of Vellore in the South Indian state of Tamil Nadu, and compared it with other diabetes risk scores developed from India.
METHODS
We used the data from 4,896 participants (30 to 64 years) of a cross-sectional study conducted in Vellore (2010 to 2012), to calculate the AMCDRS scores using age, family history, and waist circumference. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV), and the area under the receiver operating characteristic curve (AROC) were calculated for undiagnosed and total diabetes.
RESULTS
Of the 4,896 individuals surveyed, 274 (5.6%) had undiagnosed diabetes and 759 (15.5%) had total diabetes. The AMCDRS, with an optimum cut-point of ≥4, identified 45.0% for further testing with 59.5% sensitivity, 60.5% specificity, 9.1% PPV, 95.8% NPV, and an AROC of 0.639 (95% confidence interval [CI], 0.608 to 0.670) for undiagnosed diabetes. The corresponding figures for total diabetes were 75.1%, 60.5%, 25.9%, 93.0%, and 0.731 (95% CI, 0.713 to 0.750), respectively. The AROC for the AMCDRS was not significantly different from that of the Indian Diabetes Risk Score, the Ramachandran or the Chaturvedi risk scores for total diabetes, but was significantly lower than the AROC of the Chaturvedi score for undiagnosed diabetes.
CONCLUSION
The AMCDRS is a simple diabetes risk score that can be used to screen for undiagnosed and total diabetes in low-resource primary care settings in India. However, it probably requires recalibration to improve its performance for undiagnosed diabetes.

Keyword

Diabetes; Risk score; Undiagnosed; Universal screening

MeSH Terms

Cross-Sectional Studies
Humans
India*
Primary Health Care
ROC Curve
Sensitivity and Specificity
Waist Circumference

Figure

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  Fig. 1 Receiver operating characteristic curves of various risk scores for diagnosis of undiagnosed diabetes. AMCDRS, Achutha Menon Centre Diabetes Risk Score; IDRS, Indian Diabetes Risk Score.

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  Fig. 2 Receiver operating characteristic curves of various risk scores for diagnosis of total diabetes. AMCDRS, Achutha Menon Centre Diabetes Risk Score; IDRS, Indian Diabetes Risk Score.

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