Journal article
Development and external validation of a multivariable prediction model to identify nondiabetic hyperglycemia and undiagnosed type 2 diabetes: diabetes risk assessment in dentistry score (DDS)
- Abstract:
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The aim of this study was to develop and externally validate a score for use in dental settings to identify those at risk of undiagnosed nondiabetic hyperglycemia (NDH) or type 2 diabetes (T2D). The Studies of Health in Pomerania (SHIP) project comprises 2 representative population-based cohort studies conducted in northeast Germany. SHIP-TREND-0, 2008 to 2012 (the development data set) had 3,339 eligible participants, with 329 having undiagnosed NDH or T2D. Missing data were replaced using multiple imputation. Potential covariates were selected for inclusion in the model using backward elimination. Heuristic shrinkage was used to reduce overfitting, and the final model was adjusted for optimism. We report the full model and a simplified paper-based point-score system. External validation of the model and score employed an independent data set comprising 2,359 participants with 357 events. Predictive performance, discrimination, calibration, and clinical utility were assessed. The final model included age, sex, body mass index, smoking status, first-degree relative with diabetes, presence of a dental prosthesis, presence of mobile teeth, history of periodontal treatment, and probing pocket depths ≥5 mm as well as prespecified interaction terms. In SHIP-TREND-0, the model area under the curve (AUC) was 0.72 (95% confidence interval [CI] 0.69, 0.75), calibration in the large was −0.025. The point score AUC was 0.69 (95% CI 0.65, 0.72), with sensitivity of 77.0 (95% CI 76.8, 77.2), specificity of 51.5 (95% CI 51.4, 51.7), negative predictive value of 94.5 (95% CI 94.5, 94.6), and positive predictive value of 17.0 (95% CI 17.0, 17.1). External validation of the point score gave an AUC of 0.69 (95% CI 0.66, 0.71), sensitivity of 79.2 (95% CI 79.0, 79.4), specificity of 49.9 (95% CI 49.8, 50.00), negative predictive value 91.5 (95% CI 91.5, 91.6), and positive predictive value of 25.9 (95% CI 25.8, 26.0). A validated prediction model involving dental variables can identify NDH or undiagnosed T2DM. Further studies are required to validate the model for different European populations.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 93.3KB, Terms of use)
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- Publisher copy:
- 10.1177/00220345221129807
Authors
- Funder identifier:
- https://ror.org/0187kwz08
- Grant:
- NIHR300171
- Publisher:
- SAGE Publications
- Journal:
- Journal of Dental Research More from this journal
- Volume:
- 102
- Issue:
- 2
- Pages:
- 170-177
- Publication date:
- 2022-10-17
- DOI:
- EISSN:
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1544-0591
- ISSN:
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0022-0345
- Pmid:
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36254392
- Language:
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English
- Keywords:
- Pubs id:
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1287270
- Local pid:
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pubs:1287270
- Deposit date:
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2025-03-17
- ARK identifier:
Terms of use
- Copyright holder:
- International Association for Dental Research and American Association for Dental, Oral, and Craniofacial Research
- Copyright date:
- 2022
- Rights statement:
- © International Association for Dental Research and American Association for Dental, Oral, and Craniofacial Research 2022. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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