Validation of Community Based Assessment Checklist for Diabetes Mellitus in tertiary care setting, Himachal Pradesh, India.

Abstract

Background: Government of India has developed a Community Based Assessment Checklist (CBAC) as a screening tool for Hypertension, Diabetes, and Cancers (Oral, Breast, Cervix). The objective was to assess the validity of the CBAC checklist for type-2 DM at a suggested cut off score of four. Methods: Cross-sectional study was carried out in the central laboratory of medical college in the northern state of India. Total 120 already known cases of DM or had Fasting Blood Glucose (FBG) of >126 gm/dl and 120 individuals with FBG of >126 gm/dl, considered as negative for type-2 DM, were recruited. Simultaneously, CBAC checklist was administered to all the 240 participants. Results: High risk CBAC score (>4) was present in 27.5% patients with diabetes and 12.5% without diabetes (p=0.004). Risk criteria of<4 had a diagnostic accuracy of 80.5% (Sensitivity: 42.9%; Specificity: 87.5%) with positive and negative predictive value of 37.5% and 89.7% respectively. Area under curve based on Receiver Operator Characteristic (AUC-ROC) curve was observed to be 0.62 (95% CI: 0.55-0.69) (p=0.001). Conclusion: Questionnaire based CBAC risk assessment criteria as a screening tool for blood sugar assessment had poor sensitivity, good specificity and poor discriminatory ability.