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Open Access Research article

No consensus on gestational diabetes mellitus screening regimes in Sweden: pregnancy outcomes in relation to different screening regimes 2011 to 2012, a cross-sectional study

Maria Lindqvist*, Margareta Persson, Marie Lindkvist and Ingrid Mogren

BMC Pregnancy and Childbirth 2014, 14:185  doi:10.1186/1471-2393-14-185

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Need information of practical use

K Harkavy   (2014-06-09 17:05)  EMA

Sirs:

That rates of adverse outcomes rise with worsening intolerance to glucose is no surprise. What a clinician (or a group trying to develop guidelines) needs is a way to balance the benefits and risk of choosing different values to define an abnormal test, such as a OGTT. The receiver operating curve evaluates the trade off between risk and benefit at each chosen value by comparing sensitivity and specificity. A lower glucose value in an OGTT is more sensitive but less specific. A higher value is more specific but less sensitive. Furthermore, the authors also built in a screening criteria for doing the OGTT in the first place. We would need to know how this impacts sensitivity and specificity.

The presumption is that a woman who fails her OGTT by what ever criteria chosen will be placed on a treatment regimine, be it diet, oral medication, or insulin. I would like to know how many women would be treated inappropriately (ie. would have had no complications without treatment) for each woman treated to avoid a complication.

Competing interests

No competing interests

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