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Journal Club Presentation - Cross Sectional Study
Journal Club Presentation - Cross Sectional Study
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INFORMATION ON THE JOURNAL
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INFORMATION ON THE ARTICLE
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INFORMATION ON THE AUTHORS
Krutarth R Brahmbhatt Department of Community Medicine, GMERS
Medical College, Junagadh, Gujarat, India.
Tamal Chakraborty
Chandana Gopal
Shwethashree M
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SELECTED ARTICLE FOR PRESENTATION
CROSS
SECTIONAL
STUDY
DIABETES
MELLITUS
STUDY
CONDUCTED IN
KARNATAKA
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CONTENTS
❖ BACKGROUND
❖ CRITICAL APPRAISAL
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International Diabetes Federation IDF 8
VARIABLES USED IN IDRS
Abdominal Physical
obesity activity
IDRS
JC - 1
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IDRS
❖ Simplified Indian Diabetes Risk Score (IDRS).
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IDRS
Optimum Optimum
sensitivity specificity
High High
positive negative
predictive predictive
value value
JC - 1
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PREVALENCE OF DM IN INDIA
The study
As the The majority
was
prevalence of of the
conducted to
diabetes subjects
find out the
mellitus is remain
high-risk
higher in South undiagnosed
people for
India. for diabetes.
diabetes.
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02
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OBJECTIVES
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03METHODOLOGY
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STUDY DESIGN AND PARTICIPANTS
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STUDY DURATION
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
l
YEAR 2015
JANUARY TO APRIL
2015
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SAMPLE SIZE CALCULATION
• With reference to the study conducted by Ramachandran A,
et al, in India titled “High Prevalence of Diabetes and
impaired glucose tolerance in India: National Urban Diabetes
Survey (7).
• Sample size was derived by formula: 4 pq/L2,
where p = 10%,
q = 90%,
Absolute precision: 5%
=144.
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The minimum sample size for the study was concluded to be
144
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SAMPLING METHOD
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INCLUSION CRITERIA
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EXCLUSION CRITERIA
If the person was not available after two visits one more
participant was selected randomly from the list.
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STUDY TOOL
PART A PART B
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STUDY TOOL
• Questionnaire was validated for use in local language
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METHOD OF DATA COLLECTION
DATA
APPROVAL INFORMATION WRITTEN INFORMED COLLECTION
SHEETS CONSENT
Approved by the Visiting the houses of
Explained to all the Obtained from the selected
Institutional Ethics
participants all participants participants.
Committee
Data was collected by post-graduate students by interview method in the local language
OPERATIONAL DEFINITIONS
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PARTICIPANTS
WITH IDRS
I
≥60 <60 D
30- <60
R
S
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OPERATIONAL DEFINITIONS
Family history of diabetes- If either or both of a participant’s
parents had diabetes, they were considered to have a
positive family history.
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OPERATIONAL DEFINITIONS
Abdominal obesity-
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04 RESULTS
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RESULTS
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DISCUSSION
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THE PREVALENCE OF PEOPLE AT HIGH RISK
OF DIABETES WAS 34%
IN EITHER
MALES FEMALES BOTH
FEMALES MALES PARENT
44% 49% PARENT
84% 64% 22%
22%
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THE PREVALENCE OF PEOPLE AT
HIGH RISK OF DIABETES WAS 34%.
01 02 03 04
MEDICAL
URBAN AREA URBAN SLUM OF URBAN OPDS OF A
OF PUNE, AREA OF MEDICAL
PUDUCHERRY MAHARASHTRA JAMNAGAR, COLLEGE
31% 37% GUJARAT HOSPITAL
29% 25%
THE PREVALENCE OF DIABETES IS HIGHER IN SOUTH INDIA THAN OTHER PARTS OF THE
COUNTRY.
THE PREVALENCE OF ABDOMINAL OBESITY WAS 44% AND 84%
AMONG MALES AND FEMALES
01 02
NORTH INDIA USING SOUTH INDIA 31% AND
THE SAME CUT-OFF 66% AMONG MALES
VALUES OF 62% AND AND FEMALES
75% AMONG MALES
AND FEMALES
PREVALENCE OF PHYSICAL ACTIVITY AMONG MALES AND
FEMALES WAS 64% AND 49%
01 02
ICMR REPORTED
PHYSICAL AHMEDABAD, GUJARAT
PHYSICAL ACTIVITY IN
ACTIVITYIN
MALES AND FEMALES
MALES AND UP TO 68% AND 32%,
FEMALES AS 60%
AND 40%
PREVALENCE OF POSITIVE FAMILY HISTORY (IN EITHER PARENT
OR BOTH PARENTS) WAS 22%
01 02
URBAN AREA
PUNE, JAMNAGAR, GUJARAT
MAHARASHTRA PREVALENCE OF
REPORTED IT AS 23% POSITIVE FAMILY
HISTORY OF DIABETES
UP TO 18%
STRENGTH OF THE STUDY
A COMMUNITY-BASED STUDY
A VALIDATED QUESTIONNAIRE
(IDRS) WAS USED.
LIMITATIONS
3. Chaurasia H, Chaurasia RS. To find out the diabetic risk in study population by
subjecting them to Indian diabetic risk scale. Int J Med Sci Res Pract
2015;2(1):37–40.
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5. Patel DN, Shah MC, Ahir GN, Amin DV, Singh MP. A study on validity of
Indian diabetes risk score (MDRF) for screening of diabetes mellitus among the
high risk group (policemen) of diabetes mellitus of Bhavnagar city. Innovative J
Med Health Sci 2012;2:109–11.
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8. Shah B. Development of Sentinel Health Monitoring Centers for Surveillance of
Risk Factors of Non-communicable Diseases in India (April 2003 to March 2005).
Collated Results of Six Centers. New Delhi: Division of Non-communicable
Diseases, Indian Council of Medical Research, 2005. Available at: http://
www.who.int/chp/steps/IndiaSTEPSReport_6Centers.pdf (last accessed on March
10, 2016).
9. Pradeepa R, Anjana RM, Joshi SR, Bhansali A, Deepa M, Joshi PP, et al.
Prevalence of generalized & abdominal obesity in urban & rural India – the ICMR –
INDIAB Study (Phase-I) [ICMR – INDIAB-3]. Indian J Med Res 2015;142(2):139–
50.
10. Gupta SK, Singh Z, Purty AJ, Vishwanathan M. Diabetes prevalence and its
risk factors in urban Pondicherry. Int J Diabet Dev Ctries 2009;29(4):166–9.
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11. Patil RS, Gothankar JS. Assessment of risk of type 2 diabetes using the
Indian Diabetes Risk Score in an urban slum of Pune, Maharashtra, India: A
cross-sectional study. WHO South-East Asia J Public Health 2016;5(1):53–
61.
13. Bhardwaj S, Misra A, Misra R, Goel K, Bhatt SP, Rastogi K, et al. High
prevalence of abdominal, intra-abdominal and subcutaneous adiposity and
clustering of risk factors among urban Asian Indians in North India. PLoS
ONE 2011;6(9):e24362. doi:10.1371/journal.pone.0024362.
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14. Chauhan RC, Chauhan NS, Mani Kandan, Purty AJ, Mishra AK, Singh Z.
Obesity among adult population of a rural coastal area in South India. Int J
Sci Rep 2015;1(3):155–8.
15. Anjana RM, Pradeepa R, Das AK, Deepa M, Bhansali A, Joshi SR, et al.
Physical activity and inactivity patterns in India – Results from the ICMR-
INDIAB study (Phase-1) [ICMRINDIAB-5]. Int J Behav Nutr Phys Activ
2014;11:26.
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CRITICAL APPRAISAL
4 objectives.
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WAS THE STUDY DESIGN APPROPRIATE FOR
THE STATED AIMS
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WAS THE SAMPLE SIZE JUSTIFIED
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WAS THE INCLUSION/EXCLUSION CRITERIA
MENTIONED
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WAS THE TARGET/REFERENCE POPULATION
CLEARLY DEFINED
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WAS THE SAMPLE FRAME TAKEN FROM AN
APPROPRIATE POPULATION BASE
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WAS THE SELECTION PROCESS LIKELY TO
SELECT SUBJECTS/PARTICIPANTS THAT WERE
REPRESENTATIVES OF THE TARGET POPULATION
UNDER INVESTIGATION
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WERE MEASURES UNDERTAKEN TO ADDRESS
AND CATEGORISE NON RESPONDERS
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WERE THE RISK FACTOR AND OUTCOME
VARIABLES MEASURED APPROPRIATE TO THE
STUDY
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WERE THE RISK FACTOR AND OUTCOME
VARIABLES MEASURED CORRECTLY USING
INSTRUMENTS/MEASUREMENTS THAT HAD BEEN
TRIALED,PILOTED, OR PUBLISHED PREVIOUSLY
IDRS tool.
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IS IT CLEAR WHAT WAS USED TO DETERMINE
STATISTICAL SIGNIFICANCE ?
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WERE THE METHODS (INCLUDING STATISTICAL
METHODS) SUFFICIENTLY DESCRIBED TO
ENABLE THEM TO BE REPEATED?)
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WERE THE BASIC DATA ADEQUATELY
DESCRIBED?
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DOES THE RESPONSE RATE RAISE CONCERNS
ABOUT NON-RESPONSE BIAS?, IF APPROPRIATE
INFORMATION ABOUT NON-RESPONDERS
DESCRIBED?
Not mentioned and not described
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WERE THE RESULTS INTERNALLY
CONSISTENT?
JC - 1
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WERE THE RESULTS FOR THE ANALYSES
DESCRIBED IN THE METHODS, PRESENTED?
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WERE THE AUTHORS’ DISCUSSIONS AND
CONCLUSIONS JUSTIFIED BY THE RESULTS?
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WERE THERE ANY FUNDING SOURCES OR
CONFLICTS OF INTEREST THAT MAY AFFECT THE
AUTHORS’ INTERPRETATION OF THE RESULTS?
None declared.
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WAS ETHICAL APPROVAL OR CONSENT OF
PARTICIPANTS ATTAINED?
JC - 1
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WAS THE REFERENCE OF THE STUDY
APPROPRIATE?
Webpage Last accessed
1. http://www.idf.org/membership/sea/india (last
accessed on December 5, 2015).
16 REFERENCES
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Thank you