Table 3.
Performance a of screening criteria in identifying prediabetes or diabetes among US adults without diagnosed diabetes.
| Definition | Guideline | Sensitivity b | Specificity c | PPV d | NPV e | AUC f |
|---|---|---|---|---|---|---|
| Prediabetes or diabetes | ||||||
| FPG ≥ 100 mg/dL or A1C ≥ 5.7 % g | USPSTF 2015 | 51.9 (49.4–54.3) | 74.5 (72.4–76.4) | 61.5 (58.6–64.3) | 66.3 (63.8–68.7) | 62.6 (61.4–63.8) |
| USPSTF 2021 | 57.5 (55.0–59.9) | 67.1 (64.6–69.4) | 57.8 (54.9–60.7) | 66.8 (64.3–69.1) | 61.6 (60.4–62.8) | |
| ADA 2003 | 91.0 (89.1–92.6) | 35.3 (32.6–38.1) | 52.5 (50.1–54.9) | 83.3 (79.9–86.2) | 62.6 (61.6–63.5) | |
| ADA 2022 | 94.2 (92.6–95.4) | 27.6 (25.1–30.2) | 50.5 (48.2–52.9) | 85.7 (82.3–88.6) | 60.2 (59.4–61.0) | |
| FPG ≥ 100 mg/dL and A1C ≥ 5.7 % g | USPSTF 2015 | 57.7 (53.8–61.5) | 66.3 (64.4–68.2) | 22.3 (20.2–24.6) | 90.3 (89.2–91.3) | 62.5 (60.9–64.1) |
| USPSTF 2021 | 63.4 (59.8–66.9) | 59.6 (57.2–61.9) | 20.9 (18.9–22.9) | 90.6 (89.4–91.8) | 61.7 (60.1–63.3) | |
| ADA 2003 | 97.0 (94.7–98.4) | 27.2 (25.0–29.5) | 18.3 (17.0–19.7) | 98.2 (96.8–99.0) | 60.8 (60.1–61.5) | |
| ADA 2022 | 98.2 (96.3–99.2) | 20.7 (18.8–22.8) | 17.2 (16.0–18.5) | 98.6 (97.1–99.3) | 58.3 (57.7–58.9) | |
| Diabetes | ||||||
| FPG ≥ 126 mg/dL or A1C ≥ 6.5 % g | USPSTF 2015 | 59.4 (51.3–67.1) | 63.7 (61.9–65.4) | 5.4 (4.5–6.5) | 97.8 (97.2–99.3) | 61.3 (58.4–64.1) |
| USPSTF 2021 | 64.6 (55.9–72.5) | 57.0 (54.9–59.0) | 5.0 (4.2–5.9) | 97.9 (97.2–98.4) | 60.2 (57.4–63.0) | |
| ADA 2003 | 97.9 (95.9–98.9) | 24.5 (22.5–26.6) | 4.3 (3.8–5.0) | 99.7 (99.4–99.8) | 59.4 (58.5–60.3) | |
| ADA 2022 | 98.9 (98.1–99.3) | 18.6 (16.8–20.5) | 4.1 (3.5–4.7) | 99.8 (99.7–99.9) | 57.2 (56.5–58.0) | |
| FPG ≥ 126 mg/dL and A1C ≥ 6.5 % g | USPSTF 2015 | 58.9 (46.6–70.1) | 63.2 (61.4–64.9) | 2.3 (1.7–3.1) | 99.0 (98.6–99.4) | 61.4 (57.1–65.7) |
| USPSTF 2021 | 66.6 (53.5–77.5) | 56.6 (54.6–58.6) | 2.2 (1.7–2.9) | 99.1 (98.6–99.5) | 62.1 (58.0–66.2) | |
| ADA 2003 | 99.1 (93.4–99.9) | 24.1 (22.1–26.1) | 1.9 (1.5–2.4) | 99.9 (99.6–100.0) | 59.6 (58.7–60.5) | |
| ADA 2022 | 100.0 | 18.3 (16.5–20.2) | 1.8 (1.4–2.3) | 100.0 | 57.5 (57.1–58.0) | |
Abbreviations: PPV, positive predictive value; NPV, negative predictive value; USPSTF, United States Preventive Services Task Force; ADA, American Diabetes Association; DM, diabetes mellitus; FPG, fasting plasma glucose; A1c, glycated hemoglobin.
Data are presented as weighted percentages and 95% confidence intervals based on data from 6,007 adults without diagnosed diabetes, representing 207 million.
Probability of being eligible for screening among those with prediabetes or diabetes (true positives).
Probability of being ineligible for screening among those without prediabetes or diabetes (true negatives).
Probability of having prediabetes or diabetes among those eligible for screening.
Probability of not having prediabetes or diabetes among those ineligible for screening.
Probability that being eligible for screening produces a higher probability of having prediabetes or diabetes than being ineligible.
A1c values 5.7 % and 6.5 % correspond to A1c values 39 mmol/mol and 48 mmol/mol.