Ramachandran et al developed a score for identifying an urban Asian Indian at risk for developing diabetes mellitus. This can help identify patients who may benefit from prevention and closer monitoring. The authors are from M.V. Hospital for Diabetes (Tamil Nadu, India), Widdowson Laboratories (Cambridge, England) and Prince of Wales Hospital (Australia).
Parameters:
(1) age in years
(2) body mass index
(3) waist circumference by gender
(4) family history of diabetes
(5) physical activity level
Parameter
Finding
Points
age in years
< 30 years of age
0
30 - 44 years of age
10
45 to 59 years of age
18
>= 60 years of age
19
body mass index (BMI)
< 25 kg per square meter
0
>= 25 kg per square meter
7
waist measurement
male and < 85 cm
0
male and >= 85 cm
5
female and < 80 cm
0
female and >= 80 cm
5
family history of diabetes
none
0
present
7
physical activity level
sedentary with light physical activity
4
more active
0
total risk score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 42
• The higher the score the greater the risk for the patient developing diabetes.
• A score >= 22 was used to identify a patient at risk for diabetes.
Performance:
• The sensitivity at the cutoff was 77% and specificity 60% (ouch).
• The negative predictive value was 98% but the positive predictive value was 9%.
• The area under the ROC curve for the derivation cohort was 0.73.
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