How useful is clinical scoring in reducing the need for gestational diabetes screening?

International Journal of Diabetes in Developing Countries June 2012, Volume 32, Issue 2, pp 69-74


P. K. Gill, W. Y. Choo, A. M. Bulgiba


Department of Pediatrics, University Malaya Medical Centre, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.


Predicting gestational diabetes by clinical scoring is meant to improve the efficiency of screening. The aim of this study was to determine the usefulness of clinical scoring in a Malaysian population. Using a retrospective cohort of 1997 women, a predictive model was developed and validated on a separate set of 1,000 patients. The efficiency of screening with risk scores was then compared with universal screening. The model derived was well calibrated (p=0.80) with an AUC 0.74 (95 % CI 0.710.76). Different combinations of thresholds for the risk score produced a screening reduction between 26 % and 29 % (Sensitivity- 86 % compared to 97 % from universal screening) in Strategy 1. Strategy 2 had no screening reduction but had a higher sensitivity of 95 %. The performance of the risk score was moderate and the screening reduction minimal. Therefore the usefulness of clinical scoring in our population is of limited value.


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