scholarly journals Accuracy and adequacy of waist circumference cut-off points currently recommended in Brazilian adults

2013 ◽  
Vol 17 (4) ◽  
pp. 861-869 ◽  
Author(s):  
Carolina Avila Vianna ◽  
Rogério da Silva Linhares ◽  
Renata Moraes Bielemann ◽  
Eduardo Coelho Machado ◽  
David Alejandro González-Chica ◽  
...  

AbstractObjectiveTo evaluate the adequacy and accuracy of cut-off values currently recommended by the WHO for assessment of cardiovascular risk in southern Brazil.DesignPopulation-based study aimed at determining the predictive ability of waist circumference for cardiovascular risk based on the use of previous medical diagnosis for hypertension, diabetes mellitus and/or dyslipidaemia. Descriptive analysis was used for the adequacy of current cut-off values of waist circumference, receiver operating characteristic curves were constructed and the most accurate criteria according to the Youden index and points of optimal sensitivity and specificity were identified.SettingPelotas, southern Brazil.SubjectsIndividuals (n2112) aged ≥20 years living in the city were selected by multistage sampling, since these individuals did not report the presence of previous myocardial infarction, angina pectoris or stroke.ResultsThe cut-off values currently recommended by WHO were more appropriate in men than women, with overestimation of cardiovascular risk in women. The area under the receiver operating characteristic curve showed moderate predictive ability of waist circumference in men (0·74, 95 % CI 0·71, 0·76) and women (0·75, 95 % CI 0·73, 0·77). The method of optimal sensitivity and specificity showed better performance in assessing the accuracy, identifying the values of 95 cm in men and 87 cm in women as the best cut-off values of waist circumference to assess cardiovascular risk.ConclusionsThe cut-off values currently recommended for waist circumference are not suitable for women. Longitudinal studies should be conducted to evaluate the consistency of the findings.

2016 ◽  
Vol 19 (11) ◽  
pp. 1944-1951 ◽  
Author(s):  
Julia Dratva ◽  
Randi Bertelsen ◽  
Christer Janson ◽  
Ane Johannessen ◽  
Bryndis Benediktsdóttir ◽  
...  

AbstractObjectiveThe aim of the present study was to validate figural drawing scales depicting extremely lean to extremely obese subjects to obtain proxies for BMI and waist circumference in postal surveys.DesignReported figural scales and anthropometric data from a large population-based postal survey were validated with measured anthropometric data from the same individuals by means of receiver-operating characteristic curves and a BMI prediction model.SettingAdult participants in a Scandinavian cohort study first recruited in 1990 and followed up twice since.SubjectsIndividuals aged 38–66 years with complete data for BMI (n 1580) and waist circumference (n 1017).ResultsMedian BMI and waist circumference increased exponentially with increasing figural scales. Receiver-operating characteristic curve analyses showed a high predictive ability to identify individuals with BMI > 25·0 kg/m2 in both sexes. The optimal figural scales for identifying overweight or obese individuals with a correct detection rate were 4 and 5 in women, and 5 and 6 in men, respectively. The prediction model explained 74 % of the variance among women and 62 % among men. Predicted BMI differed only marginally from objectively measured BMI.ConclusionsFigural drawing scales explained a large part of the anthropometric variance in this population and showed a high predictive ability for identifying overweight/obese subjects. These figural scales can be used with confidence as proxies of BMI and waist circumference in settings where objective measures are not feasible.


Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 949
Author(s):  
Cecil J. Weale ◽  
Don M. Matshazi ◽  
Saarah F. G. Davids ◽  
Shanel Raghubeer ◽  
Rajiv T. Erasmus ◽  
...  

This cross-sectional study investigated the association of miR-1299, -126-3p and -30e-3p with and their diagnostic capability for dysglycaemia in 1273 (men, n = 345) South Africans, aged >20 years. Glycaemic status was assessed by oral glucose tolerance test (OGTT). Whole blood microRNA (miRNA) expressions were assessed using TaqMan-based reverse transcription quantitative-PCR (RT-qPCR). Receiver operating characteristic (ROC) curves assessed the ability of each miRNA to discriminate dysglycaemia, while multivariable logistic regression analyses linked expression with dysglycaemia. In all, 207 (16.2%) and 94 (7.4%) participants had prediabetes and type 2 diabetes mellitus (T2DM), respectively. All three miRNAs were significantly highly expressed in individuals with prediabetes compared to normotolerant patients, p < 0.001. miR-30e-3p and miR-126-3p were also significantly more expressed in T2DM versus normotolerant patients, p < 0.001. In multivariable logistic regressions, the three miRNAs were consistently and continuously associated with prediabetes, while only miR-126-3p was associated with T2DM. The ROC analysis indicated all three miRNAs had a significant overall predictive ability to diagnose prediabetes, diabetes and the combination of both (dysglycaemia), with the area under the receiver operating characteristic curve (AUC) being significantly higher for miR-126-3p in prediabetes. For prediabetes diagnosis, miR-126-3p (AUC = 0.760) outperformed HbA1c (AUC = 0.695), p = 0.042. These results suggest that miR-1299, -126-3p and -30e-3p are associated with prediabetes, and measuring miR-126-3p could potentially contribute to diabetes risk screening strategies.


Author(s):  
Janet L. Peacock ◽  
Philip J. Peacock

Sensitivity and specificity 340 Calculations for sensitivity and specificity 342 Effect of prevalence 344 Likelihood ratio, pre-test odds, post-test odds 346 Receiver operating characteristic (ROC) curves 348 Links to other statistics 350 In this chapter we describe how statistical methods are used in diagnostic testing to obtain different measures of a test’s performance. We describe how to calculate sensitivity, specificity, and positive and negative predictive values, and show the relevance of pre- and post-test odds and likelihood ratio in evaluating a test in a clinical situation. We also describe the receiver operating characteristic curve and show how this links with logistic regression analysis. All methods are illustrated with examples....


2016 ◽  
Vol 27 (8) ◽  
pp. 2264-2278 ◽  
Author(s):  
Liang Li ◽  
Tom Greene ◽  
Bo Hu

The time-dependent receiver operating characteristic curve is often used to study the diagnostic accuracy of a single continuous biomarker, measured at baseline, on the onset of a disease condition when the disease onset may occur at different times during the follow-up and hence may be right censored. Due to right censoring, the true disease onset status prior to the pre-specified time horizon may be unknown for some patients, which causes difficulty in calculating the time-dependent sensitivity and specificity. We propose to estimate the time-dependent sensitivity and specificity by weighting the censored data by the conditional probability of disease onset prior to the time horizon given the biomarker, the observed time to event, and the censoring indicator, with the weights calculated nonparametrically through a kernel regression on time to event. With this nonparametric weighting adjustment, we derive a novel, closed-form formula to calculate the area under the time-dependent receiver operating characteristic curve. We demonstrate through numerical study and theoretical arguments that the proposed method is insensitive to misspecification of the kernel bandwidth, produces unbiased and efficient estimators of time-dependent sensitivity and specificity, the area under the curve, and other estimands from the receiver operating characteristic curve, and outperforms several other published methods currently implemented in R packages.


Author(s):  
Shang-Ying Shiu ◽  
Constantine Gatsonis

Binary test outcomes typically result from dichotomizing a continuous test variable, observable or latent. The effect of the threshold for test positivity on test sensitivity and specificity has been studied extensively in receiver operating characteristic (ROC) analysis. However, considerably less attention has been given to the study of the effect of the positivity threshold on the predictive value of a test. In this paper we present methods for the joint study of the positive (PPV) and negative predictive values (NPV) of diagnostic tests. We define the predictive receiver operating characteristic (PROC) curve that consists of all possible pairs of PPV and NPV as the threshold for test positivity varies. Unlike the simple trade-off between sensitivity and specificity exhibited in the ROC curve, the PROC curve displays what is often a complex interplay between PPV and NPV as the positivity threshold changes. We study the monotonicity and other geometric properties of the PROC curve and propose summary measures for the predictive performance of tests. We also formulate and discuss regression models for the estimation of the effects of covariates.


Author(s):  
Pablo Martínez-Camblor ◽  
Juan Carlos Pardo-Fernández

Abstract The receiver operating characteristic (ROC) curve and their associated summary indices, such as the Youden index, are statistical tools commonly used to analyze the discrimination ability of a (bio)marker to distinguish between two populations. This paper presents the concept of Youden index in the context of the generalized ROC (gROC) curve for non-monotone relationships. The interval estimation of the Youden index and the associated cutoff points in a parametric (binormal) and a non-parametric setting is considered. Monte Carlo simulations and a real-world application illustrate the proposed methodology.


Sign in / Sign up

Export Citation Format

Share Document