Primary Care Diabetes
Volume 3, Issue 4 , Pages 211-217, November 2009

Identification of persons with dysglycemia: Terminology and practical significance

  • David F. Williamson

      Affiliations

    • Corresponding Author InformationCorresponding author at: Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd N.E., Room 740, Atlanta, GA 30322, USA. Tel.: +1 770 488 1054; fax: +1 770 488 8211.
  • ,
  • K.M. Venkat Narayan

Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA

Received 30 March 2009; received in revised form 18 August 2009; accepted 25 August 2009. published online 18 September 2009.

Abstract 

Allocating scarce resources for dysglycemia intervention requires identification of persons who will benefit. Identification has two steps: screening followed by diagnosis. Lowering a screening test's cut-off score identifies more persons with dysglycemia, but causes more normoglycemic persons to receive diagnostic testing. Raising a test's cut-off score reduces needless diagnostic testing, but increases the number falsely identified as not having dysglycemia. With limited budgets for intervention, raising a screening test's cut-off score may be appropriate. With ample budgets, lowering the test's cut-off score may be appropriate. Screening tests are most efficient in populations with high prevalence of dysglycemia.

Keywords: Screening, Diagnosis

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PII: S1751-9918(09)00086-2

doi:10.1016/j.pcd.2009.08.006

Primary Care Diabetes
Volume 3, Issue 4 , Pages 211-217, November 2009