The utility of common predictive models for detecting undiagnosed diabetes and prediabetes defined by HbA1c in a Chinese population
Authors' conclusion
The community-based program detected high proportion of Chinese adults at high-risk for undiagnosed DM and pre-DM. Utilizing strategies developed by NICE, or other international strategies, can enhance net benefits and potentially improve cost-effectiveness when compared to the current HKPCO guideline.
Study context
- Population
- Adults aged ≥25 without prior diabetes mellitus (DM) diagnoses; HbA1c point-of-care testing; DM HbA1c ≥6.5 %, pre-DM 5.7–6.4 %; age 59.3 ± 9.2 years, 39.6 % men
- Participants
- 1,810 adults
- Exposure
- Hong Kong Primary Care Office (HKPCO) strategy vs international guidelines (China, UK, US, Canada, Australia) for identifying high-risk individuals for DM and pre-DM testing
- Outcome
- Sensitivity, specificity, number needed to test (NNT) and net benefit of strategies for detecting DM and pre-DM
Methodological detailscommunity-based
- Community-based
Main finding
As reported in the abstract
Detection performance of strategies
| Group | Sensitivity | Specificity | Number needed to test |
|---|---|---|---|
| HKPCO | 100 % | 0.58 % | 20.7 |
| NICE | 96.6 % | 19.2 % | 17.6 |
Sensitivity
HKPCO100 %
NICE96.6 %
Specificity
HKPCO0.58 %
NICE19.2 %
Number needed to test
HKPCO20.7
NICE17.6
- Sensitivity range across strategies
- 19.5 % to 100 %
- Specificity range across strategies
- 0.58 % to 92.8 %
- Number needed to test range across strategies
- 8.3 to 20.7
- Fulfilled HKPCO guideline, without missing DM cases
- Over 95 %
- High-risk participants correctly reclassified by NICE criteria
- 18.6 %
Observational data: associations, not effects.
Further findings
Prevalence of DM and pre-DM by HbA1c
%
- DM
- 4.8
- Pre-DM
- 53.6
Original publication
The utility of common predictive models for detecting undiagnosed diabetes and prediabetes defined by HbA1c in a Chinese population. Diabetes Res Clin Pract. Published 25 June 2025. doi:10.
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