Validity of the FINDRISC as a prediction tool for diabetes in a contemporary Norwegian population : a 10-year follow-up of the HUNT study

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Jolle , A , Midthjell , K , Holmen , J , Carlsen , S M , Tuomilehto , J , Bjorngaard , J H & Åsvold , B O 2019 , ' Validity of the FINDRISC as a prediction tool for diabetes in a contemporary Norwegian population : a 10-year follow-up of the HUNT study ' , BMJ Open Diabetes Research & Care , vol. 7 , no. 1 , 000769 . https://doi.org/10.1136/bmjdrc-2019-000769

Title: Validity of the FINDRISC as a prediction tool for diabetes in a contemporary Norwegian population : a 10-year follow-up of the HUNT study
Author: Jolle, Anne; Midthjell, Kristian; Holmen, Jostein; Carlsen, Sven Magnus; Tuomilehto, Jaakko; Bjorngaard, Johan Håkon; Åsvold, Bjorn Olav
Contributor: University of Helsinki, Clinicum
Date: 2019-10
Language: eng
Number of pages: 9
Belongs to series: BMJ Open Diabetes Research & Care
ISSN: 2052-4897
URI: http://hdl.handle.net/10138/310671
Abstract: Objective The Finnish Diabetes Risk Score (FINDRISC) is a recommended tool for type 2 diabetes prediction. There is a lack of studies examining the performance of the current 0-26 point FINDRISC scale. We examined the validity of FINDRISC in a contemporary Norwegian risk environment. Research design and methods We followed 47 804 participants without known diabetes and aged >= 20 years in the HUNT3 survey (2006-2008) by linkage to information on glucose-lowering drug dispensing in the Norwegian Prescription Database (2004-2016). We estimated the C-statistic, sensitivity and specificity of FINDRISC as predictor of incident diabetes, as indicated by incident use of glucose-lowering drugs. We estimated the 10-year cumulative diabetes incidence by categories of FINDRISC. Results The C-statistic (95% CI) of FINDRISC in predicting future diabetes was 0.77 (0.76 to 0.78). FINDRISC >= 15 (the conventional cut-off value) had a sensitivity of 38% and a specificity of 90%. The 10-year cumulative diabetes incidence (95% CI) was 4.0% (3.8% to 4.2%) in the entire study population, 13.5% (12.5% to 14.5%) for people with FINDRISC >= 15 and 2.8% (2.6% to 3.0%) for people with FINDRISC = 15 had a positive predictive value of 13.5% and a negative predictive value of 97.2% for diabetes within the next 10 years. To approach a similar sensitivity as in the study in which FINDRISC was developed, we would have to lower the cut-off value for elevated FINDRISC to >= 11. This would yield a sensitivity of 73%, specificity of 67%, positive predictive value of 7.7% and negative predictive value of 98.5%. Conclusions The validity of FINDRISC and the risk of diabetes among people with FINDRISC >= 15 is substantially lower in the contemporary Norwegian population than assumed in official guidelines. To identify similar to 3/4 of those developing diabetes within the next 10 years, we would have to lower the threshold for elevated FINDRISC to >= 11, which would label similar to 1/3 of the entire adult population as having an elevated FINDRISC necessitating a glycemia assessment.
Subject: IMPAIRED GLUCOSE-TOLERANCE
RISK SCORE
LIFE-STYLE
PREVENTION
MELLITUS
QUESTIONNAIRE
PREVALENCE
DISEASE
OBESITY
TRENDS
3121 Internal medicine
3142 Public health care science, environmental and occupational health
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