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首页> 外文期刊>Journal of medical screening >What is the risk of mortality for people who are screen positive in a diabetes screening programme but who do not have diabetes on biochemical testing? Diabetes screening programmes from a public health perspective
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What is the risk of mortality for people who are screen positive in a diabetes screening programme but who do not have diabetes on biochemical testing? Diabetes screening programmes from a public health perspective

机译：对于在糖尿病筛查项目中筛查呈阳性但在生化检查中未患糖尿病的人来说，死亡的风险是什么？从公共卫生角度看糖尿病筛查计划

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OBJECTIVES: To assess mortality risk in people classified by the Cambridge risk score (CRS), a previously validated simple screening tool for undiagnosed type 2 diabetes that uses only information routinely available in primary care. SETTING: Random sample of the general population between 50 and 75 years of age in Hoorn, The Netherlands METHODS: The results of the CRS were compared with the gold standard for diabetes, the oral glucose tolerance test (OGTT) results classified according to the World Health Organisation (WHO) 1999 diagnostic criteria. Cox’s proportional hazards regression was used to assess the risk of mortality of screen positive and screen negative people. RESULTS: 154 people out of the total population of 2297 had previously undiagnosed diabetes and 113 (73%) of these would have been detected with the CRS (true positive). However, the CRS identified a much larger group (n=1037) who were positive for the score, but who did not have diabetes on biochemical testing (false positive). Unadjusted risk of mortality was highest in the true positive group (3.40 95% confidence interval (95% CI, 2.15 to 5.38)), intermediate in false positive people (2.62 (2.00 to 3.43)), and lowest in false negative people (1.50 (0.55 to 4.09)) with the true negative group as reference. Adjustment for age and sex resulted in similar risk estimates for all three groups, but mortality risk was significantly increased only in false positive and true positive groups compared with the true negative group. CONCLUSIONS: People who have a positive risk score are at high risk of mortality whether or not subsequent testing shows them to have diabetes. Direct public health interventions in this high risk population may be appropriate.
机译：目的：要评估通过剑桥风险评分（CRS）分类的人群的死亡风险，这是一种经过验证的，未经诊断的2型糖尿病简单筛查工具，仅使用初级保健中的常规信息。地点：荷兰霍恩，年龄在50至75岁之间的一般人群的随机样本方法：将CRS的结果与糖尿病的黄金标准进行比较，并根据世界对口服葡萄糖耐量试验（OGTT）的结果进行分类卫生组织（WHO）1999诊断标准。 Cox的比例风险回归用于评估筛查阳性和筛查阴性人群的死亡风险。结果：在2297名总人口中，有154人先前未诊断出糖尿病，其中113例（73％）可以通过CRS被检测到（真实阳性）。但是，CRS确定了一个更大的组（n = 1037），该组的分数为阳性，但在生化测试中没有糖尿病（假阳性）。在真实阳性人群中，未经调整的死亡风险最高（3.40 95％置信区间（95％CI，2.15至5.38）），在假阳性人群中处于中等水平（2.62（2.00至3.43）），在假阴性人群中最低（1.50） （0.55至4.09）），以真实否定基团为参考。对年龄和性别进行调整后，所有三组的风险估计均相似，但是与真实阴性组相比，只有假阳性和真阳性组的死亡风险显着增加。结论：风险分数为正的人无论随后的测试是否显示患有糖尿病，都有很高的死亡风险。在这种高危人群中直接采取公共卫生干预措施可能是适当的。

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