Using the AUSDRISK score to screen for pre-diabetes and diabetes in GP practices: a case-finding approach

Kerry Fleming, Natasha Weaver, Roseanne Peel, Alexis Hure, Mark McEvoy, Elizabeth Holliday, Martha Parsons, Shamasunder Acharya, Judy Luu, John Wiggers, Chris Rissel, Priyanga Ranasinghe, Ranil Jayawardena, Samir Samman, John Attia

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Abstract

Objective: To identify the optimal AUSDRISK threshold score to screen for pre-diabetes and diabetes. Methods: A total of 406 adult patients not diagnosed with diabetes were screened in General Practices (GP) between May and October 2019. All patients received a point of care (POC) HbA1c test. HbA1c test results were categorised into diabetes (≥6.5% or ≥48 mmol/mol), pre-diabetes (5.7–6.4% or 39–47 mmol/mol), or normal (<5.7% or 39 mmol/mol). Results: Of these patients, 9 (2%) had undiagnosed diabetes and 60 (15%) had pre-diabetes. A Receiver Operator Characteristic (ROC) curve was constructed to predict the presence of pre-diabetes and diabetes; the area under the ROC curve was 0.72 (95%CI 0.65–0.78) indicating modest predictive ability. The optimal threshold cut point for AUSDRISK score was 17 (sensitivity 76%, specificity 61%, + likelihood ratio (LR) 1.96, - likelihood ratio of 0.39) while the accepted cut point of 12 performed less well (sensitivity 94%, specificity 23%, +LR=1.22 -LR+0.26). Conclusions: The AUSDRISK tool has the potential to be used as a screening tool for pre-diabetes/diabetes in GP practices. A cut point of ≥17 would potentially identify 75% of all people at risk and three in 10 sent for further testing would be positive for prediabetes or diabetes. Implications for public health: Routine case-finding in high-risk patients will enable GPs to intervene early and prevent further public health burden from the sequelae of diabetes.

Original languageEnglish
Pages (from-to)203-207
Number of pages5
JournalAustralian and New Zealand Journal of Public Health
Volume46
Issue number2
Early online date11 Nov 2021
DOIs
Publication statusPublished - Apr 2022
Externally publishedYes

Keywords

  • AUSDRISK
  • diabetes
  • pre-diabetes
  • prevention
  • primary care

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