ROC-curves—fundamentals for proper use

Excerpt

We read with interest the article by Chume and co-workers entitled ‘Is there a role for glycated albumin in the diagnosis of gestational diabetes mellitus?’, recently published in Endocrine [1]. The aim of the study was to assess the clinical utility of glycated albumin (GA) in the diagnosis of gestational diabetes. The authors present Receiver Operating Characteristics (ROC) curves of GA, glycated hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) using the Oral Glucose Tolerance Test (OGTT) as the diagnostic test (gold standard). The area under the curve (AUC) values reported are 0.531, 0.743, and 0.865 for GA, HbA1c and FPG, respectively. The authors conclude that GA does not have the ability to correctly discriminate those with and without gestational diabetes. Hence, they disapprove the use of GA as a standalone diagnostic test of GDM. We agree with Chume and co-workers in that conclusion. In our ROC analysis of GA and HbA1c in the diagnostics of gestational diabetes in Norwegian women, we found similar results with AUC values of 0.531 (GA) and 0.623 (HbA1c) [2]. …