RESUMO
Early detection of people with undiagnosed type 2 diabetes (T2D) is an important public health concern. Several predictive equations for T2D have been proposed but most of them have not been externally validated and their performance could be compromised when clinical data is used. Clinical practice guidelines increasingly incorporate T2D risk prediction models as they support clinical decision making. The aims of this study were to systematically review prediction scores for T2D and to analyze the agreement between these risk scores in a large cross-sectional study of white western European workers. A systematic review of the PubMed, CINAHL, and EMBASE databases and a cross-sectional study in 59,042 Spanish workers was performed. Agreement between scores classifying participants as high risk was evaluated using the kappa statistic. The systematic review of 26 predictive models highlights a great heterogeneity in the risk predictors; there is a poor level of reporting, and most of them have not been externally validated. Regarding the agreement between risk scores, the DETECT-2 risk score scale classified 14.1% of subjects as high-risk, FINDRISC score 20.8%, Cambridge score 19.8%, the AUSDRISK score 26.4%, the EGAD study 30.3%, the Hisayama study 30.9%, the ARIC score 6.3%, and the ITD score 3.1%. The lowest agreement was observed between the ITD and the NUDS study derived score (κ = 0.067). Differences in diabetes incidence, prevalence, and weight of risk factors seem to account for the agreement differences between scores. A better agreement between the multi-ethnic derivate score (DETECT-2) and European derivate scores was observed. Risk models should be designed using more easily identifiable and reproducible health data in clinical practice.
RESUMO
La intención del presente estudio es evaluar por un lado el nivel de conocimiento y el grado de valoración del Servicio de Prevención en un colectivo de trabajadores de Baleares, y por otro hacer un repaso de la influencia que determinadas variables sociodemográficas tienen en estos valores. 1154 trabajadores responden a un cuestionario elaborado por nosotros donde se recogen datos sociodemográficos y específicos de prevención. El nivel de conocimiento sobre la existencia del SPRL es elevado (71,63%). Dentro de las especialidades preventivas la más conocida es la Seguridad (84,7%). La valoración media obtenida es de 5,84 puntos. El 86,4% dan una valoración de 5 o más puntos. Hay diferencias estadísticamente significativas en los resultados obtenidos según nivel de estudios, formación previa en prevención, opinión que se tenga de la influencia que tiene el SPRL en la mejora de las condiciones de trabajo y según lo que se opine sobre el grado de independencia del SPRL. Por el contrario no hay diferencias por sexo, edad o antigüedad en el trabajo
The intention of this study is to evaluate the degree, on the one hand, of the level of awareness and the value given to the Prevention Services within a group of workers in the Balearics, and on the other hand, review the influence that certain sociodemographic variables have on these values. 1154 workers responded to a questionnaire we prepared where socio-demographic and specific prevention data were collected. The level of awareness of the existence of SPRL is high (71,63%). The specific prevention group most known is Safety (84.7%). The average value given is 5.84 points. 86,4% give 5 or more pointes. There are significant statistical differences in the results obtained according to the level of studies, previous training in prevention, ones opinion on the influence the SPRL has to better working conditions, and ones opinion on the degree of independence the SPRL has. On the contrary there were no differences observed based on sex, age and amount of time employed
