Table 3.
Performance of sets of selective screening criteria for diabetes mellitus among participants in SUNSET
| Source | AUC (bCI)c | Sens (%, CI) | Spec (%, CI) | Screen (%) | Prev (%) | NNS | ||
| Set criteria for Hindustani Surinamese | ||||||||
| 1 | age ≥ 45 years | DCGP | 0.62 (0.58–0.67) |
66.3 (55.2–75.9) |
57.6 (51.2–63.8) |
48.5 | 35.0 | 3 |
| 2 | age ≥ 45 and BMI > 25 kg/m2 | ADA | 0.65 (0.61–0.71) |
66.3 (55.2–75.9) |
57.6 (51.2–63.8) |
48.5 | 35.0 | 3 |
| 3 | criteria 2, and have additional risk factors, as followsa | ADA extended | 0.74 (0.70–0.79) |
79.5 (69.0–87.3) |
47.4 (41.0–53.8) |
56.4 | 35.5 | 3 |
| 4 | tailored risk scoreb | present study | 0.74 (0.70–0.79) |
75.9 (65,.0–84.3) |
54.1 (47.6–60.4) |
53.5 | 35.8 | 3 |
| Set criteria for African Surinamese | ||||||||
| 1 | age ≥ 45 years | DCGP | 0.62 (0.58–0.67) |
62.7 (50.7–73.3) |
61.4 (57.0–65.6) |
41.7 | 19.0 | 6 |
| 2 | age ≥ 45 and BMI > 25 kg/m2 | ADA | 0.68 (0.65–0.75) |
59.5 (47.4–70.5) |
72.6 (68.5–76.3) |
81.1 | 14.2 | 8 |
| 3 | criteria 2, and have additional risk factors, as followsa | ADA extended | 0.79 (0.76–0.85) |
78.1 (66.6–86.6) |
60.7 (56.3–65.0) |
44.1 | 22.1 | 5 |
| 4 | tailored risk scoreb | present study | 0.80 (0.75–0.85) |
79.2 (67.7–87.5) |
62.3 (57.9–66.5) |
42.8 | 23.0 | 5 |
| Set criteria for ethnic Dutch | ||||||||
| 1 | age ≥ 45 years | DCGP | 0.57 (0.51–0.63) |
78.8 (60.6–90.4) |
35.6 (31.2–40.2) |
65.4 | 8.2 | 13 |
| 2 | age ≥ 45 and BMI > 25 kg/m2 | ADA | 0.72 (0.65–0.77) |
72.7 (54.2–86.1) |
72.7 (60.3–69.3) |
79.8 | 8.0 | 13 |
| 3 | criteria 2, and have additional risk factors, as followsa | ADA extended | 0.79 (0.75–0.87) |
71.9 (53.0–85.6) |
71.2 (66.7–75.3) |
31.7 | 15.0 | 7 |
| 4 | tailored risk scoreb | present study | 0.78 (0.73–0.85) |
77.4 (58.5–89.7) |
68.8 (64.2–73.1) |
34.3 | 14.9 | 7 |
a physically inactive or 1st-degree relative with DM or high risk ethnic group (Hindustani Surinamese, i.e. South Asian) or hypertensive or reduced HDL and/or elevated triglyceride or history of cardiovascular disease.
b optimal screening criteria identified from multivariate analysis (ethnic groups, age, BMI, waist circumference, resting heart rate, first-degree relative with DM, hypertension, history of cardiovascular disease)
c bCI: The 'Confidence interval' around the score was estimated via a bootstrapping procedure [20], the 2.5 and 97.5 percentiles are listed between brackets. The cut-off value for the SUNSET score was 0.200 for Hindustani Surinamese, 0.077 for African Surinamese and 0.055 for ethnic Dutch. DM = diabetes mellitus (fasting plasma glucose ≥ 7.0 mmol/l and/or self-reported), CI = 95%-confidence interval, DCPG = Dutch College of General Practitioners, ADA = American Diabetes Association, AUC = area under the curve, a measure of diagnostic accuracy, sens = sensitivity of the criteria (value closest to, but not over 80%), spec = specificity corresponding to the listed sensitivity, screen = percentage of the total population in this study that is screened, prev = prevalence in the screened population (the predictive value positive), NNS = number needed to screen to detect a case of DM in this study, BMI = body mass index