Know that risk assessment questionnaires developed to screen for diabetes have inadequate sensitivity and specificity in identifying persons with undiagnosed diabetes.

• See table Operating Characteristics for Various Tests in Screening for Diabetes.

Evidence:

• The questionnaire, “Take the Test, Know the Score,” developed by the ADA, which provides a score based on a family history of diabetes, a history of a macrosomic infant, BMI, age, and physical inactivity, was associated with a sensitivity of 78% and a specificity of 50% for the detection of undiagnosed diabetes in 1471 U.S. adults (66).
• The Finnish Diabetes Risk Score, which incorporates data on BMI, age, hypertension, diet, and physical activity, found that a score 9 had a sensitivity of 76% to 77% and a specificity of 66% to 68% for identifying persons with previously undiagnosed diabetes in two cohorts of 4435 Finnish subjects aged 35 to 64 years (69).
• A questionnaire incorporating age, obesity, physical inactivity, family history of diabetes, hypertension, and BMI was tested in a cohort of 2364 Dutch subjects aged 50 to 74 years, and it was found to be 72% to 78% sensitive and 55% specific for detecting undiagnosed diabetes (70).

Comments:

• None.