Screening performance of community-based assessment checklist compared with point of care screening tests to identify high-risk individuals for diabetes and hypertension in urban Mysore, India.

Background and objectives This study validates the discriminative ability of a community-based assessment checklist (CBAC) compared with other point-of-care tools for community screening to identify individuals at high risk of diabetes and hypertension. The data for this study were collected during 2019-20 in selected areas of Mysuru city, Karnataka. Methods CBAC was administered to residents aged 30 yrs and above, without known cases of diabetes mellitus, hypertension, or cancer. Random capillary blood glucose (RCBG) and blood pressure (BP) were measured for comparison with the CBAC score. Screening performance was assessed using receiver operating characteristics (ROC) analysis and the area under the curve (AUC). Results CBAC was administered to 32,686 people, and 31,594 had complete data for CBAC and RBS, and 32,645 had both CBAC scores and BP values. The analysis showed a poor AUC of 0.62 (95% CI: 0.61-0.63) for identifying individuals at risk of diabetes with RCBG value of ≥140 mg/dL and an AUC of 0.61 (95% CI: 0.60-0.61) for individuals at risk of hypertension with BP values of (systolic ≥140 mmHg OR diastolic ≥90 mmHg). Youden's index indicated that the CBAC cut-off of >4, though optimal for both at-risk of diabetes and hypertension, was poor at 0.17 and 0.15, respectively. Interpretation and conclusions The discriminative ability of CBAC was found to be poor compared with other point-of-care tools. We propose that trained frontline health staff administer RCBG and BP tests alongside the CBAC to enable more efficient public health triaging.