Presenter:Zheng-kun Shi Supervisor:Si-yuan Tang Monica Parry

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Eileen Houston
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1 Presenter:Zheng-kun Shi Supervisor:Si-yuan Tang Monica Parry

2 Meet us Zheng-kun Shi, Master candidate, RN Si-yuan Tang, Professor, PhD, Doctoral supervisor, Postdoctoral Supervisor, Dean of Xiang Ya School of Nursing, CSU, Director of Health Care Research Center, CSU Monica Parry, NP-Adult, PhD, Assistant Professor, Director of the Nurse Practitioner Programs, University of Toronto

Nursing, CSU, Director of Health Care Research Center, CSU Monica Parry,

3 1 Background 2 Objective 3 Methods 4 Results 5 Conclusion

4 1 Background 2 Objective 3 Methods 4 Results 5 Conclusion

5 Background Global prevalence IDF DIABETES ATLAS - 7TH EDITION (2015) 1 in 11 adults have diabetes (415 million) By 2040, 1 adult in 10 (642 million) will have diabetes

6 Background Global prevalence Every 6 seconds a person dies from diabetes (5.0 million deaths) 1 in 2 diabetes remain undiagnosed

7 Background China prevalence The prevalence of diabetes in Chinese adults rose to 11.6% in 2010 (113.9 million), which was the highest in the world.

8 Background Diabetes Risk Score Although the Oral glucose tolerance testing (OGTT) and Hemoglobin A1c (HbA1c) test are the golden diagnose tests for diabetes, they are invasive and usually not appropriate for universal screening. Many countries recommend the selfadministrated risk score (questionnaire) in a population-based screening for diabetes prevention because it is accurate, quick, easyaccess, and cheap, particularly in the lessdeveloped areas.

Many countries recommend the selfadministrated risk score (questionnaire) in a population-based screening for

9 Background Diabetes Risk Score Although academics have introduced or developed some diabetes risk assessment tools of Chinese version, there is no unified or recognized diabetes risk assessment tool in China.

assessment tools of Chinese version, there is no

10 1 Background 2 Objective 3 Methods 4 Results 5 Conclusion

11 Objectives To introduce the validated Canadian Diabetes Risk Assessment Questionnaire (CANRISK) to Chinese population. To evaluate its accuracy and discrimination for detecting diabetes and prediabetes (dysglycemia).

12 1 Background 2 Objective 3 Methods 4 Results 5 Conclusion

13 Methods A two-phase design was used for this study. Phase I was instrument translation, adaptation and content validation of the CANRISK. Phase II was accuracy and discrimination evaluation of CHINARISK.

14 Methods Sample size The diagnostic test formula: N= [Uα 2 *p (1-p)] /δ 2 α =0.05, δ = 0.10, sensitivity = 80%,specificity =60% ascertained by previous published data. 116 in control group. Sample size = in case group

15 Methods Inclusion criterion included: 1. never diagnosed with diabetes years old 3. ability to read and speak in Mandarin Chinese Exclusion criterion: Serious medical or psychiatric condition as documented in patient s chart by a physician

16 Methods The participants were approached when they did medical visits in Changsha city from October 2014 to April 2015: one diabetes clinic of the Second Xiang Ya Hospital one in physical examination center of Xiang Ya Hospital one in Wangyue Hu community health center *This study was approved by the Human Subjects Boards of Xiang Ya Nursing School of Central South University and other appropriate ethic committees of participant hospitals and communities in China.

one in Wangyue Hu community health center *This study was approved by the Human Subjects Boards of Xiang Ya Nursing

17 Methods Self-reported measurements : Socio-demographic and Clinic Data Sheet CHINARISK FINDRISC

18 Statistical methods Convergent validity was calculated by the Pearson correlation analysis between the scores of CHINARISK and the scores of FINDRISC. Criterion validity was calculated by the Pearson correlation analysis between the scores of CHINARISK and OGTT-2h results. Receiver operating characteristic (ROC) curve analysis was used to examine the sensitivity and specificity of the CHINRISK.

Criterion validity was calculated by the Pearson correlation analysis between the scores of

19 1 Background 2 Objective 3 Methods 4 Results 5 Conclusion

20 Results--Phase 1 Translation validity and content validity of the CHINARISK TVI for the entire instrument, as computed at score 4, was 98.3%. For content validation, after two rounds of Delphi, the S-CVI/UA (scale-level CVI/universal agreement) for CHINARISK was 0.95 and the S-CVI/Ave(scale-level CVI/average) is 0.90, with I-CVI (item-level CVI) ranged from 0.83 to 1.00.

For content validation, after two rounds of Delphi, the S-CVI/UA (scale-level CVI/universal

21 Results--Demographic

22 Results--Criterion-related validity The mean score of CHINARISK was (SD was ) in this sample and the mean score of FINDRISC was 8.93 (SD was 4.235). There was positive relationship between CHINARISK and OGTT- 2h results (r=0.300, p<0.001). The relationship between FINDRISC and OGTT-2h results (r=0.242, p<0.001) was also positive.

Results--Sensitivity and specificity The AUC of CHINRISK was 0.703 (95%CI, 0.630-0.776), which was higher than 0.665 (95%CI, 0.587-0.742) for FINDRISC.

23 Results--Sensitivity and specificity The AUC of CHINRISK was (95%CI, ), which was higher than (95%CI, ) for FINDRISC. At a cut-off score of 30, the sensitivity would be 67%, specificity would be 67%, positive predictive value (PPV) would be 58%, and negative predictive value (NPV) would be 75% to diagnose IFG/IGT/diabetes.

24 1 Background 2 Objective 3 Methods 4 Results 5 Conclusion

25 Conclusion The information of acceptable psychometric properties presented supports the use of the CHINARISK as an evidence-based and valid measure to identify individuals with high risk of diabetes in Chinese population. Anyone who scores higher than 30 of the CHINARISK is recommended to take clinical diabetes diagnoses test. The CHINARISK shows the potential of working as a universal screening tool of diabetes, which may play an important role in diabetes prevention for Chinese adults.

27 Shi

How To Understand And Understand The Concept Of Intermediate Hyperglycaemia

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