scholarly journals Effectiveness of the CANRISK tool in the identification of dysglycemia in a Canadian South Asian Population

2018 ◽  
Vol 38 (7/8) ◽  
pp. 286-294 ◽  
Author(s):  
Gina Agarwal ◽  
Ying Jiang ◽  
Chantal Lemieux ◽  
Susan Rogers Van Katwyk ◽  
Yang Mao ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Logistic Regression ◽  
Sensitivity And Specificity ◽  
Assessment Tool ◽  
South Asians ◽  
Predictive Ability ◽  
Risk Assessment Tool ◽  
Average Risk ◽  
Entire Study ◽  
Scoring Algorithm

Introduction South Asians have a higher than average risk of developing type 2 diabetes. We ascertained the effectiveness of CANRISK, an existing diabetes risk assessment tool, examining its sensitivity and specificity at two different predetermined scoring cut-off points comparing those participants under the age of 40 and those 40 and over. We examined the predictive ability of a model based on CANRISK variables, comparing ethno-specific body mass index (BMI) and waist circumference (WC) cut-off points with the original BMI and WC cut-off points to see if predictive ability could be improved for this population. Methods Canadian South Asians of unknown diabetes status, age 18 to 78, were recruited across seven provinces from various community or health centers. CANRISK variables were collected followed by oral glucose tolerance testing. Descriptive analysis, logistic regression including alternative ethno-specific BMI and WC cut-off points, and sensitivity and specificity analyses were performed. Results 832 participants were recruited (584 under age 40). Using the entire study sample, logistic regression models including CANRISK variables predicted dysglycemia effectively (AUC of 0.80). However, by using alternative BMI/WC cut-off points with the scoring algorithm, predictive power via AUC was not improved. Sensitivity and specificity of CANRISK using the original pre-determined “high risk” cut-off point of 33 points in individuals age 40 years or over were 93% and 35%, respectively; in individuals under 40, these were 33% and 92%, respectively. Using the lower pre-determined “moderate risk” cut-off point of 21 points improved the sensitivity to 77% and specificity to 53% in the younger age group. Conclusion The existing CANRISK is an adequate risk assessment tool for dysglycemia in Canadian South Asians for those age 40 years and over; however, the tool does not work as well for individuals under 40. The lower cut-off of 21 points may be warranted for younger individuals to minimize false negatives. Ethno-specific BMI/WC cutoff points did not improve predictive ability of the CANRISK scoring algorithm as measured by AUC.

Further validation of an opioid risk assessment tool: The Brief Risk Interview

2014 ◽  
Vol 10 (5) ◽  
pp. 353 ◽  
Author(s):  
Ted Jones, PhD ◽  
Samantha Lookatch, MA ◽  
Patricia Grant, MS, ANP-C ◽  
Janice McIntyre, MS, ANP-C ◽  
Todd Moore, PhD
Keyword(s):  
Risk Assessment ◽  
Chronic Pain ◽  
Assessment Tool ◽  
Predictive Accuracy ◽  
Training Session ◽  
Predictive Ability ◽  
Standard Of Care ◽  
Assessment Tools ◽  
Risk Assessment Tool ◽  
Aberrant Behavior

Opioids remain a common method of treating chronic pain conditions despite some controversy. In an effort to address some of the risks of opioid medications, opioid risk assessment has become a standard of care when opioids are used to treat a chronic pain condition. Research to date has found that clinical interviews may be superior to currently available patient-completed written questionnaires in identifying patients likely to engage in medication aberrant behavior. The Brief Risk Interview (BRI) has been developed as a risk assessment tool that has the sensitivity of a clinical interview while eliminating the need for the lengthy process of an interview. The current study compared the predictive ability of the BRI with two commonly used patient-completed risk assessment tools: the Opioid Risk Tool (ORT) and the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R). After clinical staff at a pain practice underwent a 1-hour training program, 124 consecutive new patients were evaluated using the BRI, ORT, and SOAPP-R. Follow-up data found that the BRI was a good predictor of medication aberrant behavior and offered better sensitivity and better overall predictive accuracy than the ORT or the SOAPP-R. Overall, it appears that the BRI is a valid risk assessment tool that, after a brief training session, can be used effectively by pain clinicians. Further study is needed in other practice settings and with larger sample sizes.

Validation of the NCI colorectal cancer risk assessment tool in the CSP 380 veterans cohort.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15135-e15135
Author(s):  
Laura W. Musselwhite ◽  
Thomas S. Redding ◽  
Kellie J. Sims ◽  
Meghan O'Leary ◽  
Elizabeth R. Hauser ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Assessment ◽  
Predictive Value ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Sensitivity Analyses ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Male Veterans

e15135 Background: Refining screening to colorectal cancer (CRC) risk may promote screening effectiveness. We applied the National Cancer Institute (NCI) CRC Risk Assessment Tool to estimate 5- and 10-year CRC risk in an average-risk Veterans cohort undergoing screening colonoscopy with follow-up. Methods: This was a prospective evaluation of predicted to actual risk of CRC using the NCI CRC Risk Assessment Tool in male Veterans undergoing screening colonoscopy with a median follow-up of 10 years.Family, medical, dietary and physical activity histories were collected at enrollment and used to calculate absolute 5- and 10-year CRC risk, and to compare tertiles of expected to observed CRC risk. Sensitivity analyses were performed. Results: For 2,934 male Veterans with complete data (average age 62.4 years, 15% minorities), 1.3% (N=30) and 1.7% (N=50) were diagnosed with CRC within 5 and 10 years of survey completion. The area under the curve for predicting CRC was 0.69 (95% CI; 0.61-0.78) at 5 years and 0.67 (95% CI, 0.59-0.75) at 10 years. We calculated the sensitivity (0.60, 95% CI; 0.45-0.73), specificity (0.67, 95% CI; 0.65-0.69) positive predictive value (0.031, 95% CI; 0.02-0.04) and negative predictive value (0.99, 95% CI; 0.98-0.99). Conclusions: The NCI CRC Risk Assessment Tool was well-calibrated at 5 years and overestimated CRC risk at 10 years, had modest discriminatory function, and a high NPV in a cohort of ethnically diverse male Veterans. This tool reliably excludes 10-year CRC in low-scoring individuals and may inform patient-provider decision making when the benefit of screening is uncertain. [Table: see text]

scholarly journals Risk of Advanced Neoplasia Using the National Cancer Institute’s Colorectal Cancer Risk Assessment Tool

2016 ◽  
Vol 109 (1) ◽  
Author(s):  
Thomas F Imperiale ◽  
Menggang Yu ◽  
Patrick O Monahan ◽  
Timothy E Stump ◽  
Rebeka Tabbey ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Assessment ◽  
Assessment Tool ◽  
Colorectal Neoplasia ◽  
Risk Assessment Tool ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Tubular Adenoma ◽  
Advanced Neoplasia ◽  
Current Risk

Background: There is no validated, discriminating, and easy-to-apply tool for estimating risk of colorectal neoplasia. We studied whether the National Cancer Institute’s (NCI’s) Colorectal Cancer (CRC) Risk Assessment Tool, which estimates future CRC risk, could estimate current risk for advanced colorectal neoplasia among average-risk persons. Methods: This cross-sectional study involved individuals age 50 to 80 years undergoing first-time screening colonoscopy. We measured medical and family history, lifestyle information, and physical measures and calculated each person’s future CRC risk using the NCI tool’s logistic regression equation. We related quintiles of future CRC risk to the current risk of advanced neoplasia (sessile serrated polyp or tubular adenoma ≥ 1 cm, a polyp with villous histology or high-grade dysplasia, or CRC). All statistical tests were two-sided. Results: For 4457 (98.5%) with complete data (mean age = 57.2 years, SD = 6.6 years, 51.7% women), advanced neoplasia prevalence was 8.26%. Based on quintiles of five-year estimated absolute CRC risk, current risks of advanced neoplasia were 2.1% (95% confidence interval [CI] = 1.3% to 3.3%), 4.8% (95% CI = 3.5% to 6.4%), 6.4% (95% CI = 4.9% to 8.2%), 10.0% (95% CI = 8.1% to 12.1%), and 17.6% (95% CI = 15.5% to 20.6%; P < .001). For quintiles of estimated 10-year CRC risk, corresponding current risks for advanced neoplasia were 2.2% (95% CI = 1.4% to 3.5%), 4.8% (95% CI = 3.5% to 6.4%), 6.5% (95% CI = 5.0% to 8.3%), 9.3% (95% CI = 7.5% to 11.4%), and 18.4% (95% CI = 15.9% to 21.1%; P < .001). Among persons with an estimated five-year CRC risk above the median, current risk for advanced neoplasia was 12.8%, compared with 3.7% among those below the median (relative risk = 3.4, 95 CI = 2.7 to 4.4). Conclusions: The NCI’s Risk Assessment Tool, which estimates future CRC risk, may be used to estimate current risk for advanced neoplasia, making it potentially useful for tailoring and improving CRC screening efficiency among average-risk persons.

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