Using DBS data to assess disease prevalence
overestimation of disease, diabetes
DISEASE, DIABETES
Using total cholesterol, HbA1c and CRP data, we compared the prevalence of disease in venous and venous-equivalent DBS. Comparable measurements should lead to a similar prevalence of disease in nurse and self-collection mode. However, participants who reported doctor diagnosed diabetes were less likely to provide a venous sample than take part in the nurse home visit. In the population that provided a venous sample, reported any diabetes diagnosis and had HbA1c values measured, 5.7% of participants report that a doctor told them they have diabetes compared to 8.7% who had diagnosed diabetes in those that provided a self-collected DBS sample and had their HbA1c values analysed (Table Unweighted and weighted percentages for those diagnosed with diabetes and above clinical cut points in serum-equivalent DBS based measures of HbA1c, total cholesterol and C-reactive protein.In venous-equivalent DBS measurements an overestimation of disease for diabetes prevalence may have occurred. However, there may also be an underestimation of diabetes in the nurse visit as the prevalence of doctor diagnosed diabetes is lower than in DBS arm of the experiment. Further, it was noted that higher proportion of HbA1c values above 3SD were found in those reporting doctor diagnosed diabetes in the nurse visit than in from those reporting doctor diagnosed and providing a DBS (Supplementary Materials 