Evidence map›Paper›PMID 28384264›Full record

SynthesisPloS one2017

Risk factor screening to identify women requiring oral glucose tolerance testing to diagnose gestational diabetes: A systematic review and meta-analysis and analysis of two pregnancy cohorts.

Diane Farrar, Mark Simmonds, Maria Bryant, Debbie A Lawlor, Fidelma Dunne, Derek Tuffnell, Trevor A Sheldon

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 4 pooled it
8.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 92 citations in OpenAlex.

  1. Pooled it
  2. Serum levels of adipokines in gestational diabetes: a systematic review.Journal of endocrinological investigation · 2019
    Pooled it
  3. Atencion primaria · 2018
    Guideline
  4. Pooled it
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Article
  10. Fasting plasma glucose performs better than glycated hemoglobin and glycated albumin for diagnosing gestational diabetes.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Exploring Structural Uncertainty in Cost-Effectiveness Modeling of Gestational Diabetes Screening: An Application Example from Norway.Medical decision making : an international journal of the Society for Medical Decision Making · 2024
    Article
  16. Review
  17. Article
  18. Risk Estimation of Gestational Diabetes Mellitus in the First Trimester.The Journal of clinical endocrinology and metabolism · 2023
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Diane FarrarBradford Institute for Health Research, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom.ORCID http://orcid.org/0000-0002-5625-761X
Mark SimmondsCentre for Reviews and Dissemination, University of York, York, United Kingdom.
Maria BryantBradford Institute for Health Research, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, United Kingdom.
Debbie A LawlorMRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom.
Fidelma DunneGalway Diabetes Research Centre (GDRC) and School of Medicine, National University of Ireland, Galway, Republic of Ireland.
Derek TuffnellBradford Women's and Newborn Unit, Bradford, United Kingdom.
Trevor A SheldonDepartment of Health Sciences, University of York, York, United Kingdom.
University of York · GBBradford Royal Infirmary · GBOllscoil na Gaillimhe – University of Galway · IEUniversity of Bristol · GBUniversity of Leeds · GB

Funding

Department of Health 11/99/02Medical Research Council MC_UU_12013/5
6 · The paper itself

Abstract

backgroundEasily identifiable risk factors including: obesity and ethnicity at high risk of diabetes are commonly used to indicate which women should be offered the oral glucose tolerance test (OGTT) to diagnose gestational diabetes (GDM). Evidence regarding these risk factors is limited however. We conducted a systematic review (SR) and meta-analysis and individual participant data (IPD) analysis to evaluate the performance of risk factors in identifying women with GDM.

methodsWe searched MEDLINE, Medline in Process, Embase, Maternity and Infant Care and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2016 and conducted additional reference checking. We included observational, cohort, case-control and cross-sectional studies reporting the performance characteristics of risk factors used to identify women at high risk of GDM. We had access to IPD from the Born in Bradford and Atlantic Diabetes in Pregnancy cohorts, all pregnant women in the two cohorts with data on risk factors and OGTT results were included.

resultsTwenty nine published studies with 211,698 women for the SR and a further 14,103 women from two birth cohorts (Born in Bradford and the Atlantic Diabetes in Pregnancy study) for the IPD analysis were included. Six studies assessed the screening performance of guidelines; six examined combinations of risk factors; eight evaluated the number of risk factors and nine examined prediction models or scores. Meta-analysis using data from published studies suggests that irrespective of the method used, risk factors do not identify women with GDM well. Using IPD and combining risk factors to produce the highest sensitivities, results in low specificities (and so higher false positives). Strategies that use the risk factors of age (>25 or >30) and BMI (>25 or 30) perform as well as other strategies with additional risk factors included.

conclusionsRisk factor screening methods are poor predictors of which pregnant women will be diagnosed with GDM. A simple approach of offering an OGTT to women 25 years or older and/or with a BMI of 25kg/m2 or more is as good as more complex risk prediction models. Research to identify more accurate (bio)markers is needed. Systematic Review Registration: PROSPERO CRD42013004608.

Indexed as

Glucose Tolerance TestCohort StudiesDiabetes, GestationalFemaleHumansPregnancyRisk Factors

Identifiers

PMID28384264
PMCPMC5383279
OpenAlexW2604250350

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.