Utilidad diagnóstica de la prueba de riesgo de la Asociación Americana de Diabetes para prediabetes y diabetes. Una revisión sistemática y metaanálisis

Abstract

Introduction: Given the increase in cases of prediabetes and type 2 diabetes mellitus (DM2) worldwide, and the limited access to laboratory analysis in several places, it is necessary to have the implementation of a simple, fast, and without-detection method. laboratory: the American Diabetes Association (ADA) risk test: the ADA test risk score (ADATRS). Objective: To carry out a systematic review (SR) with meta-analysis on the diagnostic utility of the ADATRS for prediabetes and DM2. Methodology: SR with meta-analysis of studies of diagnostic tests. The search was conducted in four databases: PubMed/Medline, SCOPUS, Web of Science and EMBASE. True positives, true negatives, false positives, and false negatives were obtained for each study. 2×2 tables were constructed based on the information from the article or from the authors. Thus, forest diagrams were presented with a 95% confidence interval (95%CI), both for the overall sensitivity and specificity of the ADATRS for both events of interest. Results: Forest plots revealed that the sensitivity and specificity for prediabetes were 0.91 (95%CI: 0.82-0.96) and 0.52 (95%CI: 0.36-0.67), respectively. While for DM2, the combined sensitivity and specificity were 0.85 (95%CI: 0.71-0.93) and 0.56 (95%CI: 0.47-0.65), respectively. Conclusions: Our systematic review and meta-analysis of the current literature suggests that the ADATRS may be useful as a screening method for prediabetes and DM2, given its high sensitivity. However, there is a lot of heterogeneity and few studies even in this regard; therefore, more research work is needed in different populations and with more standardized methods to finally determine the clinical importance of this questionnaire as a screening or diagnostic tool for prediabetes or DM2.