Diagnostic utility of the American Diabetes Association risk test for prediabetes and diabetes. A systematic review and meta-analysis

Introduction: Given the increase in cases of prediabetes and type 2 diabetes mellitus (DM2) worldwide, and the limited access to laboratory analysis in several places, it is necessary to have the implementation of a simple, fast, and without-detection method. laboratory: the American Diabetes Association (ADA) risk test: the ADA test risk score (ADATRS). Objective: To carry out a systematic review (SR) with meta-analysis on the diagnostic utility of the ADATRS for prediabetes and DM2. Methodology: SR with meta-analysis of studies of diagnostic tests. The search was conducted in four databases: PubMed/Medline, SCOPUS, Web of Science and EMBASE. True positives, true negatives, false positives, and false negatives were obtained for each study. 2x2 tables were constructed based on the information from the article or from the authors. Thus, forest diagrams were presented with a 95% confidence interval (95%CI), both for the overall sensitivity and specificity of the ADATRS for both events of interest. Results: Forest plots revealed that the sensitivity and specificity for prediabetes were 0.91 (95%CI: 0.82-0.96) and 0.52 (95%CI: 0.36-0.67), respectively. While for DM2, the combined sensitivity and specificity were 0.85 (95%CI: 0.71-0.93) and 0.56 (95%CI: 0.47-0.65), respectively. Conclusions: Our systematic review and meta-analysis of the current literature suggests that the ADATRS may be useful as a screening method for prediabetes and DM2, given its high sensitivity. However, there is a lot of heterogeneity and few studies even in this regard; therefore, more research work is needed in different populations and with more standardized methods to finally determine the clinical importance of this questionnaire as a screening or diagnostic tool for prediabetes or DM2.