Evaluation of the Use of a Diabetes Risk Test to Identify Prediabetes in an Employee Wellness Screening

Background: The American Diabetes Association (ADA) Diabetes Risk Test (DRT) is a screening tool to identify people at risk for developing diabetes. Individuals with a DRT score of 5 or higher may have prediabetes or diabetes and should see a healthcare provider. Objective: To determine how many additional employees are identified as being at risk for developing diabetes during an employee wellness screening by using a more stringent DRT cutoff score of 4 instead of 5. Methods: During an annual employee wellness screening event, a hemoglobin A1C (A1c) was drawn for participants with a DRT score of > 4 or by request regardless of risk score. A1C values were classified as normal (<5.7%), prediabetes (>5.7 and <6.5%) or diabetes (>6.5%). Risk scores and A1C values were analyzed using descriptive statistics. Cost of additional laboratory testing was also reviewed. Results: An A1C was collected for 158 participants. Fourteen of 50 (28%) participants with a DRT of 4 had A1c values in the prediabetes range and no history of diabetes or prediabetes. Using the lower DRT score of 4 resulted in an additional expenditure of $305 with $85.40 resulting in the identification of an otherwise unaware person at risk for developing diabetes. Conclusion: Using a DRT cutoff score of 4 as part of an employee wellness screening program resulted in additional laboratory costs to identify persons at risk for developing diabetes but also allowed for earlier education to slow or stop the progression to diabetes which may reduce healthcare costs over time.

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Diabetes Risk Scores in 2011

European Endocrinology ◽

10.17925/ee.2011.07.01.19 ◽

2010 ◽

Vol 7 (1) ◽

pp. 19

Author(s):

Beverley Balkau ◽

Lei Chen ◽

◽

Keyword(s):

At Risk ◽

Prediction Interval ◽

Routine Care ◽

Diabetes Risk ◽

Intensive Treatment ◽

Screening Tools ◽

Risk Scores ◽

Family History Of Diabetes ◽

Dutch Study ◽

History Of

Diabetes risk scores can be used as pre-screening tools to detect those likely to have diabetes. Scores usually include clinical characteristics such as age, sex, family history of diabetes and hypertension. However, it is disputed whether screening for diabetes is cost-effective. The recently reported Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION) study, in which diabetes was diagnosed following screening by a risk score, did not show that intensive treatment in such individuals was different from routine care in terms of cardiovascular outcomes. Risk scores are also used to identify those at risk of diabetes in the future, and at-risk individuals may then be encouraged to participate in diabetes prevention programmes. Risk scores from routine biology, in particular fasting glucose, have also been developed to improve prediction over clinical risk factors. Now more sophisticated approaches are being used to predict diabetes – multiple biomarkers, genetics, proteomics, lipidomics and metabolomics – with the idea that if individuals are identified a long time in advance of the onset of the disease, prevention can start much earlier when it may be more successful. Diabetes risk scores follow on from a long history of cardiovascular risk scores. Scores should be given with an uncertainly or prediction interval within which the score lies with 95% confidence.

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Development and Validation of a Novel Dementia Risk Score in the UK Biobank Cohort

10.31234/osf.io/5yvjr ◽

2021 ◽

Author(s):

Melis Anatürk ◽

Raihaan Patel ◽

Georgios Georgiopoulos ◽

Danielle Newby ◽

Anya Topiwala ◽

...

Keyword(s):

At Risk ◽

Cardiovascular Risk ◽

Risk Score ◽

Disease Risk ◽

Risk Index ◽

Risk Scores ◽

Uk Biobank ◽

Dementia Risk ◽

History Of ◽

The Uk

INTRODUCTION: Current prognostic models of dementia have had limited success in consistently identifying at-risk individuals. We aimed to develop and validate a novel dementia risk score (DRS) using the UK Biobank cohort.METHODS: After randomly dividing the sample into a training (n=166,487, 80%) and test set (n=41,621, 20%), logistic LASSO regression and standard logistic regression were used to develop the UKB-DRS.RESULTS: The score consisted of age, sex, education, apolipoprotein E4 genotype, a history of diabetes, stroke, and depression, and a family history of dementia. The UKB-DRS had good-to-strong discrimination accuracy in the UKB hold-out sample (AUC [95%CI]=0.79 [0.77, 0.82]) and in an external dataset (Whitehall II cohort, AUC [95%CI]=0.83 [0.79,0.87]). The UKB-DRS also significantly outperformed four published risk scores (i.e., Australian National University Alzheimer’s Disease Risk Index (ANU-ADRI), Cardiovascular Risk Factors, Aging, and Dementia score (CAIDE), Dementia Risk Score (DRS), and the Framingham Cardiovascular Risk Score (FRS) across both test sets.CONCLUSION: The UKB-DRS represents a novel easy-to-use tool that could be used for routine care or targeted selection of at-risk individuals into clinical trials.

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Unfavorable inflammatory profile in adults at risk of type 2 diabetes identified by hemoglobin A1c levels according to the American Diabetes Association criteria

Acta Diabetologica ◽

10.1007/s00592-014-0647-2 ◽

2014 ◽

Vol 52 (2) ◽

pp. 349-356 ◽

Cited By ~ 8

Author(s):

T. V. Fiorentino ◽

M. L. Hribal ◽

M. Perticone ◽

F. Andreozzi ◽

A. Sciacqua ◽

...

Keyword(s):

Type 2 Diabetes ◽

At Risk ◽

American Diabetes Association ◽

Hemoglobin A1c ◽

Inflammatory Profile

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Creating a Swallow Screening Program at Mass General Hospital: A Model for Development and Implementation

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd18.4.123 ◽

2009 ◽

Vol 18 (4) ◽

pp. 123-128 ◽

Cited By ~ 7

Author(s):

Audrey K. Cohen

Keyword(s):

At Risk ◽

General Hospital ◽

Administrative Support ◽

Screening Tool ◽

Screening Program ◽

Massachusetts General Hospital ◽

Competency Assessment ◽

Performance Measurements ◽

Patients At Risk ◽

Swallow Screening

Abstract The Massachusetts General Hospital-Swallow Screening Tool (MGH-SST) is a two-part dysphagia screening tool for use by trained staff working with acute neuroscience patients. It was developed in 2004 for use on our neuroscience inpatient units using factors sensitive to aspiration risk. The MGH-SST provides early detection of those at risk for aspiration, guides the decision whether a patient can safely eat or drink, and acts as a trigger for appropriate speech--language pathology (SLP) consult for a comprehensive swallow evaluation. A staff education module was developed including a training video with clinical examples to simulate disordered clinical features, as well as a competency assessment. The MGH-SST was validated using trained nurses with patients with a broad range of neurological and neurosurgical injuries, comparing the MGH-SST results to an instrumental dysphagia assessment, fiberoptic endoscopic evaluation of swallowing (FEES). It was found to be a valid and effective screening to identify patients at risk for dysphagia. Elements critical to the success of a dysphagia screening program include multi-disciplinary collaboration, administrative support, comprehensive training to ensure reliable and consistent administration, and continuous performance measurements.

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Development and validation of a diabetes risk score among two populations

PLoS ONE ◽

10.1371/journal.pone.0245716 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245716

Author(s):

Natalie V. Schwatka ◽

Derek E. Smith ◽

Ashley Golden ◽

Molly Tran ◽

Lee S. Newman ◽

...

Keyword(s):

Risk Score ◽

Screening Program ◽

Diabetes Risk ◽

Risk Scores ◽

P Value ◽

Working Population ◽

The Future ◽

Study Population ◽

Diabetes Risk Score

The purpose of this study was to assess the validity of a practical diabetes risk score amongst two heterogenous populations, a working population and a non-working population. Study population 1 (n = 2,089) participated in a large-scale screening program offered to retired workers to discover previously undetected/incipient chronic illness. Study population 2 (n = 3,293) was part of a Colorado worksite wellness program health risk assessment. We assessed the relationship between a continuous diabetes risk score at baseline and development of diabetes in the future using logistic regression. Receiver operating curves and sensitivity/specificity of the models were calculated. Across both study populations, we observed that participants with diabetes at follow-up had higher diabetes risk scores at baseline than participants who did not have diabetes at follow-up. On average, the odds ratio of developing diabetes in the future was 1.38 (95% CI: 1.26–1.50, p < 0.0001) for study population 1 and 1.68 (95% CI: 1.45–1.95, p-value < 0.0001) for study population 2. These findings indicate that the diabetes risk score may be generalizable to diverse individuals, and thus potentially a population level diabetes screening tool. Minimally-invasive diabetes risk scores can aid in the identification of sub-populations of individuals at risk for diabetes.

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Knowledge About Type 2 Diabetes Risk and Prevention of African-American and Hispanic Adults and Adolescents With Family History of Type 2 Diabetes

The Diabetes Educator ◽

10.1177/0145721709341851 ◽

2009 ◽

Vol 35 (5) ◽

pp. 836-842 ◽

Cited By ~ 27

Author(s):

Karen Weber Cullen ◽

Bonnie B. Buzek

Keyword(s):

Type 2 Diabetes ◽

At Risk ◽

African American ◽

Risk Factor ◽

Family History ◽

Diabetes Risk ◽

Hispanic Families ◽

Tenth Grade ◽

History Of

Purpose The purpose of this study was to assess type 2 diabetes knowledge, perceptions, risk factor awareness, and prevention practices among African American and Hispanic families with a history of diabetes. Methods Ninth and tenth grade Houston area students who had a parent who spoke English or Spanish and had a family history of type 2 diabetes were recruited. Student interviews took place during lunch. Parents were interviewed via telephone. Open-ended questions in the interview guide assessed knowledge of diabetes and risk factors, diabetes prevention practices, and perceived risk. Students reported dietary behaviors. Responses were recorded. Results Interviews were conducted with 39 parents (95% female, 49% African-American, 51% Hispanic) and 21 ninth and tenth grade adolescents (71% female, 43% African-American, 57% Hispanic). The majority were overweight. Approximately one-half of both groups reported some knowledge of diabetes. The majority (74%) of parents correctly identified family history as a risk factor, but few adolescents responded correctly. Being overweight was identified as a risk factor by 26% of the parents and 10% of the adolescents. Losing weight was not acknowledged as a way to reduce diabetes risk. Sweetened beverage consumption consisted of 2 cans/day and 43% reported to have skipped breakfast. Conclusions Overall, there was a lack of knowledge about risk and prevention of type 2 diabetes among African American and Hispanic families at risk. From a public health perspective, there is a critical need for innovative prevention programs targeting families at risk for diabetes.

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Phonological Awareness Screening to Identify At-Risk Readers

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.2902.109 ◽

1998 ◽

Vol 29 (2) ◽

pp. 109-116 ◽

Cited By ~ 14

Author(s):

Margie Gilbertson ◽

Ronald K. Bramlett

Keyword(s):

At Risk ◽

Phonological Awareness ◽

Reading Ability ◽

At Risk Students ◽

First Grade ◽

Receptive Vocabulary ◽

Standardized Assessments ◽

Cutoff Score ◽

Invented Spelling ◽

Reading Measures

The purpose of this study was to investigate informal phonological awareness measures as predictors of first-grade broad reading ability. Subjects were 91 former Head Start students who were administered standardized assessments of cognitive ability and receptive vocabulary, and informal phonological awareness measures during kindergarten and early first grade. Regression analyses indicated that three phonological awareness tasks, Invented Spelling, Categorization, and Blending, were the most predictive of standardized reading measures obtained at the end of first grade. Discriminant analyses indicated that these three phonological awareness tasks correctly identified at-risk students with 92% accuracy. Clinical use of a cutoff score for these measures is suggested, along with general intervention guidelines for practicing clinicians.

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Opportunistic Colorectal Cancer Screening using Colonoscopy. Comparative Results between two Historical Cohorts in Bucharest, Romania

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.242.buch ◽

2015 ◽

Vol 24 (2) ◽

pp. 171-176 ◽

Cited By ~ 1

Author(s):

Elena Mirela Ionescu ◽

Tudor Nicolaie ◽

Serban Ion Gologan ◽

Ana Mocanu ◽

Cristina Ditescu ◽

...

Keyword(s):

Colorectal Cancer ◽

Screening Program ◽

Advanced Adenoma ◽

Detection Rates ◽

Incidence And Mortality ◽

Organized Screening Program ◽

History Of ◽

Comparative Results ◽

Asymptomatic Individuals ◽

Second Period

Background & Aims: Even though Romania has one of the highest incidence and mortality in colorectal cancer (CRC) in Europe, there is currently no organized screening program. We aimed to assess the results of our opportunistic CRC screening using colonoscopy.Methods: A single center retrospective study to include all opportunistic screening colonoscopies performed in two 18 month periods (2007-2008 and 2012-2013) was designed. All asymptomatic individuals without a personal or family history of adenoma or CRC and with complete colonoscopy performed in these two time periods were included.Results: We included 1,807 individuals, 882 in the first period, 925 in the second period. There were 389 individuals aged below 50, 1,351 between 50 and 75 and 67 older than 75 years. There were 956 women (52.9%), with a mean age of 58.5 (median 59, range 23-97). The detection rates were 12.6% for adenomas (6.1% for advanced adenoma) and 3.4% for adenocarcinoma. Adenoma incidence (4.9% in subjects under 50, 14.7% in those aged 50 to 75, and 16.4% in those older than 75, p<0.0001) and size (6.3mm in subjects younger than 50, 9.2mm in those 50 to 75 and 10.8mm in those older than 75, p=0.015) significantly increased with age. Adenoma incidence increased in the second period (14.8% vs. 10.3%, p=0.005), while adenoma size decreased in the second period (8.4mm vs. 10mm, p=0.006). There were no procedure related complications.Conclusions: The neoplasia detection rate was 16% (12.6% adenoma, 3.4% adenocarcinoma). Adenoma incidence and size increased with age in both cohorts. In the second screening period significantly more and smaller adenomas were detected.

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Dental Implant Placement in Patients with a History of Medications Related to Osteonecrosis of the Jaws: A Systematic Review

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00351 ◽

2020 ◽

Author(s):

Judd Sher ◽

Kate Kirkham-Ali ◽

Denny Luo ◽

Catherine Miller ◽

Dileep Sharma

Keyword(s):

Systematic Review ◽

At Risk ◽

Drug Therapy ◽

Dental Implant ◽

Case Series ◽

Cochrane Central Register ◽

Bisphosphonate Treatment ◽

Implant Placement ◽

Increased Risk ◽

History Of

The present systematic review evaluates the safety of placing dental implants in patients with a history of antiresorptive or antiangiogenic drug therapy. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. PubMed, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and OpenGrey databases were used to search for clinical studies (English only) to July 16, 2019. Study quality was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases using a modified Newcastle-Ottawa scale and the Joanna Briggs Institute critical appraisal checklist for case series. A broad search strategy resulted in the identification of 7542 studies. There were 28 studies reporting on bisphosphonates (5 cohort, 6 case control, and 17 case series) and one study reporting on denosumab (case series) that met the inclusion criteria and were included in the qualitative synthesis. The quality assessment revealed an overall moderate quality of evidence among the studies. Results demonstrated that patients with a history of bisphosphonate treatment for osteoporosis are not at increased risk of implant failure in terms of osseointegration. However, all patients with a history of bisphosphonate treatment, whether taken orally for osteoporosis or intravenously for malignancy, appear to be at risk of ‘implant surgery-triggered’ MRONJ. In contrast, the risk of MRONJ in patients treated with denosumab for osteoporosis was found to be negligible. In conclusion, general and specialist dentists should exercise caution when planning dental implant therapy in patients with a history of bisphosphonate and denosumab drug therapy. Importantly, all patients with a history of bisphosphonates are at risk of MRONJ, necessitating this to be included in the informed consent obtained prior to implant placement. The James Cook University College of Medicine and Dentistry Honours program and the Australian Dental Research Foundation Colin Cormie Grant were the primary sources of funding for this systematic review.

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