Dataset Information

Effect of the Standardization of Diagnostic Tests on the Prevalence of Diabetes Mellitus and Impaired Fasting Glucose.

ABSTRACT:

Background

Without standardization of medical laboratory's testing practices, there is an increase in false diagnoses when relying on test results. However, the effect of test standardization is difficult to assess numerically. This study's purpose is to quantify the effect of the standardization level of a laboratory on the prevalence of diabetes mellitus (DM) and impaired fasting glucose (IFG).

Methods

Laboratories were classified into three levels: 'highly-standardized laboratory,' 'basically-standardized laboratory,' and 'non-standardized laboratory.' Based on the results of Korean External Quality Assessment Scheme (KEQAS), the cutoff values for diagnosis of DM and IFG were recalculated, given false positive and false negative rates.

Results

The prevalence of DM and IFG in the population as a whole was estimated using the 2013 Korea National Health and Nutrition Examination Survey (KNHANES) database. When the prevalence of DM from KNHANES was 11.88% (95% confidence interval [CI], 10.59%-13.17%), the proportion with a systematic false error ranged from 10.91% (95% CI, 9.65%-12.17%) to 13.09% (95% CI, 11.74%-14.45%). The prevalence of IFG varied from 13.59% (95% CI, 12.25%-14.91%) to 40.49% (95% CI, 38.54%-42.43%), in contrast to 24.58% (95% CI, 22.85%-26.31%) of the reference value. The prevalence of DM and IFG tended to be over- and under-estimated more as the laboratory standardization level became lower, respectively.

Conclusion

Our study proved that standardization of clinical laboratory tests is an important factor affecting the prevalence estimation of national disease statistics based on the simulation using KNHANES data.

SUBMITTER: Lee B

PROVIDER: S-EPMC5832944 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Publications

Effect of the Standardization of Diagnostic Tests on the Prevalence of Diabetes Mellitus and Impaired Fasting Glucose.

Lee Bora B Lee Ji Sung JS Lee Yong Wha YW Jang Mi Ae MA Song Junghan J Kim Jeong Ho JH Lee Wee Gyo WG Min Won Ki WK Lee Juneyoung J Lee You Kyoung YK

Journal of Korean medical science 20180305 10

<h4>Background</h4>Without standardization of medical laboratory's testing practices, there is an increase in false diagnoses when relying on test results. However, the effect of test standardization is difficult to assess numerically. This study's purpose is to quantify the effect of the standardization level of a laboratory on the prevalence of diabetes mellitus (DM) and impaired fasting glucose (IFG).<h4>Methods</h4>Laboratories were classified into three levels: 'highly-standardized laborato ...[more]

PMID: 29495144

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Project description:BackgroundTeachers are responsible for educating future generations and therefore play an important role in a country's education system. Teachers constitute about 2.6% of all employees in Malaysia, making it one of the largest workforces in the country. While health and well-being are crucial to ensuring teachers' work performance, reports on non-communicable diseases such as type 2 diabetes mellitus (T2DM) among Malaysian teachers are scarce. Hence, this study focused on the prevalence of T2DM, undiagnosed diabetes mellitus (DM), impaired fasting glucose (IFG), and underlying lifestyle factors associated with these outcomes among Malaysian teachers.MethodsThis is a cross-sectional study from the CLUSTer cohort. There were 14144 teachers from the Peninsular Malaysia included in this study. The teachers' sociodemographic and lifestyle characteristics were described using a weighted complex analysis. A matched age group comparison was carried out between teachers and the Malaysian general population on T2DM, undiagnosed DM, and IFG status. Next, the researchers examined the association of lifestyle factors with T2DM and IFG using multivariable logistic regression.ResultsThe prevalence of T2DM, undiagnosed DM, and IFG among the Malaysian teachers were 4.1%, 5.1%, and 5.6%, respectively. The proportions of teachers with T2DM (both diagnosed and undiagnosed) and the IFG increased linearly with age. Teachers had a lower weighted prevalence of T2DM (known and undiagnosed) than the general population. However, teachers were more inclined to have IFG than the general population, particularly those aged 45 years and older. Among all lifestyle indicators, only waist circumference (aOR: 1.14, 95% CI: 1.08, 1.20) was found to be associated with T2DM, whereas waist circumference (aOR: 1.10, 95% CI: 1.05, 1.15) and physical activity [moderately active = (aOR: 0.71, 95% CI: 0.52, 0.98); highly active = (aOR: 0.56, 95% CI: 0.40, 0.80)] were associated with IFG.ConclusionsModifiable lifestyle factors such as abdominal obesity and physical activity were associated with T2DM and IFG. Intervention programs targeting these factors could help reduce future treatment costs and increase productivity.

Project description:BackgroundThe extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain.MethodsWe calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies.ResultsAfter adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths.ConclusionsIn addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.).

Dataset Information

Effect of the Standardization of Diagnostic Tests on the Prevalence of Diabetes Mellitus and Impaired Fasting Glucose.

Background

Methods

Results

Conclusion

Publications

Effect of the Standardization of Diagnostic Tests on the Prevalence of Diabetes Mellitus and Impaired Fasting Glucose.

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