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Archived Comments for: 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

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  1. Need information of practical use

    K Harkavy, EMA

    9 June 2014

    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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