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Faculty of Public Health Medicine Summer Scientific May 26 & 27, 2021

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Faculty of Public Health Medicine Summer Scientific May 26 & 27, 2021 Faculty of Public Health Medicine Summer Scientific May 26 & 27, 2021 Posters Contents Page Submission ID Poster Title 3 Comparing non-Invasive Diabetes Risk Scores for Detecting Patients in Clinical Practice 43 The Burden of Alcohol Related Morbidity and Mortality for 2019 in six Nordic Countries 2 Learning from the experience of Contract Tracers working during the COVID19 Outbreak 35 Cookstove Interventions to reduce exposure to household are pollution in sub-Saharan Africa: A scoping review to inform intervention research 44 Well-being Interventions and Support during Epidemics: Protocol for qualitative longitudinal study of older adults’ experiences during COVID-19 38 DCOVID-19 pandemic impact on employment and mental health in a high risk group-People with Cystic Fibrosis (PWCF) 7 We can Quit2-Results of a pilot randomized controlled trial of a community-based smoking cessation intervention for disadvantaged women in Ireland 6 A breakpoint modelling approach to assess the temporal link between non-pharmaceutical interventions and the incidence of symptomatic COVID-19 in the Republic of Ireland 5 Prognostic modelling of COVID-19 severity in the Republic of Ireland from February to December 29 From evidence to implementation and evaluation: Developing the Self-Harm Assessment and Management for General Hospitals (SAMAGH) Training Programme 41 BreastCheck detected Ductal Carcinoma in Situ, 2008-2020 14 Traumatic Brain Injury Rehabilitation: Preliminary Results from an Irish Study 18 Proposed European contact tracing indicators: does Irish data measure up? 23 An overview of the establishment of a national contact tracing programme in Ireland: A Quality Improvement Approach in a Time of Pandemic 21 A Health Needs Assessment for the Establishment of a Donor Human Milk Bank in the Republic of Ireland 37 Epidemiology of COVID-19 and public health restrictions during the first year of the pandemic in Ireland in 2020/2021 27 An evaluation of a new classification to identify people with Traumatic Brain Injury in routine acute care data. Comparing Non-Invasive Diabetes Risk Scores for Detecting Patients in Clinical Practice Sinéad Flynn1, Seán R. Millar*1, Claire M. Buckley1, Kate Junker1, Catherine Phillips1,2, Janas M. Harrington1 1HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Ireland 2School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland Background and Objectives Results Type 2 diabetes is a significant cause of morbidity and Figure 1. Receiver operating characteristic (ROC) curves to discriminate mortality and previous research suggests that 41% of diabetes prevalent type 2 diabetes comparing diabetes risk scores using optimal cut-offs. cases in Ireland’s middle-aged population are undiagnosed. Non-invasive risk scores have been developed with the aim of identifying patients with undiagnosed diabetes and may present a cost-effective method for screening on a large scale. However, currently no risk score has been validated in an Irish population. The aim of this study was to apply nine diabetes risk scores to an Irish dataset to determine which score is most appropriate for use in an Irish population. Study Design The Cork and Kerry Diabetes and Heart Disease Study (Mitchelstown Cohort) was a single centre, cross-sectional • The Cambridge Diabetes Risk Score (AUC=0.78, 95% CI: 0.75–0.82), Leicester Diabetes Risk study conducted between 2010 and 2011, based on a Score (AUC=0.78, 95% CI: 0.75–0.82), Rotterdam Predictive Model 2 (AUC=0.78, 95% CI: 0.74– 0.82) and the U.S. Diabetes Risk Score (AUC=0.78, 95% CI: 0.74–0.81) displayed the largest population representative random sample of 2,047 men and AUC values at optimal cut-offs and as continuous variables, as seen in Figure 1 and Table 1. women aged 46–73 years (49% male). Clinical measurements were taken by researchers who were thoroughly trained according to the study research protocols. For this study, type Table 1. Diagnostic statistics for risk scores to discriminate type 2 diabetes. 2 diabetes was determined according to a glycated Score AUC Optimal cut-off AUC at cut-off Prevalence at cut-off Sens Spec +LR -LR PPV NPV haemoglobin A1C level ≥6.5% (≥48 mmol/mol) or a fasting (95% CI) (95% CI) (%) plasma glucose level ≥7.0 mmol/l. Brazil Diabetes Risk Score 0.71 (0.68–0.75) 20.5 0.68 (0.64–0.72) 47.7 0.81 0.55 1.8 0.35 0.14 0.97 Cambridge Diabetes Risk 0.78 (0.75–0.82) 0.56 0.73 (0.69–0.77) 34.6 0.77 0.69 2.5 0.33 0.18 0.97 Score Danish Diabetes Risk Score 0.77 (0.73–0.80) 38.5 0.70 (0.65–0.74) 35.5 0.71 0.68 2.2 0.43 0.16 0.96 Statistical Analysis FINDRISC Concise Model 0.72 (0.68–0.76) 9.5 0.68 (0.64–0.72) 40.7 0.74 0.62 2.0 0.42 0.15 0.96 FINDRISC Full model 0.73 (0.70–0.77) 9.5 0.69 (0.65–0.73) 45.1 0.80 0.58 1.9 0.34 0.14 0.97 Receiver operating characteristic (ROC) curve analysis was Leicester Diabetes Risk Score 0.78 (0.75–0.82) 21.5 0.71 (0.67–0.75) 38.0 0.76 0.65 2.2 0.37 0.16 0.97 used to assess the ability of diabetes risk scores and risk score Rotterdam Predictive Model 1 0.71 (0.67–0.75) 9.5 0.66 (0.61–0.70) 43.2 0.72 0.59 1.8 0.47 0.13 0.96 components to discriminate prevalent type 2 diabetes cases. Rotterdam Predictive Model 2 0.78 (0.74–0.82) 42.0 0.72 (0.68–0.76) 29.2 0.69 0.74 2.7 0.42 0.19 0.97 The area under the curve (AUC) provides a scale of 0.5 to 1 U.S. Diabetes Risk Score 0.78 (0.74–0.81) 5.5 0.71 (0.67–0.76) 21.9 0.61 0.82 3.4 0.48 0.22 0.96 (0.5 representing random chance and 1 indicating perfect • Among risk scores, AUC values ranged from 0.71–0.78. Prevalence at optimal cut-offs, which discrimination) by which to compare the ability of a marker to illustrates how many patients would undergo further invasive testing, ranged from 21.9–47.7%. detect a positive result. Optimal cut-off thresholds for diabetes risk scores were determined using the method that finds the Table 2. Comparison of the four best performing risk scores at fixed sensitivities. cut-point which has a sensitivity and specificity closest to the Prevalence top left of the ROC space. AUC Sensitivity Cut-off at the cut- Spec +LR -LR PPV NPV off (%) Cambridge Diabetes 0.78 Risk Score 0.95 (fixed) 0.23 64.5 0.38 1.5 0.13 0.12 0.99 0.90 (fixed) 0.30 57.8 0.45 1.6 0.22 0.12 0.98 Conclusions 0.85 (fixed) 0.41 47.8 0.56 1.9 0.27 0.14 0.98 0.80 (fixed) 0.46 42.8 0.60 2.0 0.33 0.15 0.97 Leicester Diabetes 0.78 • In this middle to older-aged population, diabetes cases Risk Score 0.95 (fixed) 15.5 64.8 0.38 1.5 0.16 0.12 0.99 were best detected by the Cambridge, Leicester, 0.90 (fixed) 17.5 56.2 0.47 1.7 0.21 0.13 0.98 0.85 (fixed) 18.5 51.6 0.51 1.7 0.29 0.13 0.97 Rotterdam PM2 and U.S. diabetes risk scores. 0.80 (fixed) 20.5 42.3 0.61 2.1 0.33 0.15 0.97 Rotterdam PM2 0.78 0.95 (fixed) 32.41 72.5 0.30 1.4 0.17 0.11 0.99 • The Cambridge model had the largest AUC value at an 0.90 (fixed) 34.16 64.6 0.38 1.5 0.26 0.11 0.98 0.85 (fixed) 37.42 49.7 0.53 1.8 0.28 0.14 0.98 optimal cut-off, can be easily accessed online for use in 0.80 (fixed) 38.83 42.4 0.61 2.1 0.33 0.15 0.97 U.S. Diabetes Risk 0.78 a clinical setting and may be most appropriate for Score 0.95 (fixed) 3.5 67.9 0.34 1.4 0.15 0.11 0.99 detecting undiagnosed diabetes cases in an Irish 0.90 (fixed)1 - - - - - - - 0.85 (fixed)1 - - - - - - - population. 0.80 (fixed) 4.5 43.6 0.60 2.0 0.33 0.15 0.97 1There were no cut-offs corresponding to these sensitivities. • Non-invasive risk scores may present a feasible method • The four best performing scores: Cambridge, Leicester, Rotterdam PM2 and U.S. diabetes risk for screening prevalent diabetes cases on a large-scale, scores, were compared at fixed sensitivities. thus allowing for earlier interventions to prevent the • When using risk score cut-offs corresponding to 80% sensitivity, 42–44% of patients would undergo further blood testing, with a specificity range of 60–61%. Positive predictive values at this development of diabetes-related complications such as sensitivity were 15% for all four scores. diabetic retinopathy and cardiovascular disease. HRB Centre for HealthHRB and Centre Diet for Health and Diet Research Research *For further information, please contact Seán Millar Email: [email protected] *For further information, please contact Seán Millar Email: [email protected] THE BURDEN OF ALCOHOL RELATED MORBIDITY AND MORTALITY FOR 2019 IN SIX NORDIC COUNTRIES 2 2 2 1 1School of Public Heath, University College Cork, Cork City.
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