Variability of Diabetes Alert Dog Accuracy in a Real-World Setting.
Variability of Diabetes Alert Dog Accuracy in a Real-World Setting.
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DOI：
10.1177/1932296816685580
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发表时间：
2017-07-01
影响因子：
5
通讯作者：
McElgunn, Zachary R
中科院分区：
文献类型：
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作者：
Gonder-Frederick, Linda A;Grabman, Jesse H;McElgunn, Zachary R
背景：糖尿病警戒犬(DADS)作为1型糖尿病(T1D)患者血糖监测的一种替代方法越来越受欢迎。只有几项实证研究评估了DAD的准确性，结果不一致。本研究使用方便的所有者报告日记样本来检验DAD在现实条件下的准确性和变异性。方法：18名DAD所有者(44.4%是女性；77.8%是年轻人)在放置后的第一年完成了T1D的DAD警报日记。日记条目包括每天的血糖读数和爸爸的警报。对于每个DAD，计算命中百分比(用BG≤5.0或≥11.1mmo1/L报警；≤90或≥2 0 0 mg/dl)、错过百分比(无BG超出范围的报警)和假报警(BG在范围内的报警)。还计算了敏感性、特异性、阳性似然比(PLR)和真阳性率。结果：DAD命中与未命中的总体比较显示，低血糖和高血糖的命中率明显更高。总敏感性为57.0%，其中低血糖敏感性(59.2%)高于高血糖敏感性(56.1%)。总特异度为49.3%，PLR=1.12。然而，在DADS中观察到准确性的高度变异性，BG敏感性从33%到100%不等。达到≥60%、65%和70%真阳性率的父亲分别为71%、50%和44%。结论：父亲可能能够发现超出范围的血糖，但父亲之间的差异明显。需要更大规模的试验来进一步评估DAD的准确性，并确定在BG检测中影响DAD准确性的因素。
BACKGROUND: Diabetes alert dogs (DADs) are growing in popularity as an alternative method of glucose monitoring for individuals with type 1 diabetes (T1D). Only a few empirical studies have assessed DAD accuracy, with inconsistent results. The present study examined DAD accuracy and variability in performance in real-world conditions using a convenience sample of owner-report diaries.METHOD: Eighteen DAD owners (44.4% female; 77.8% youth) with T1D completed diaries of DAD alerts during the first year after placement. Diary entries included daily BG readings and DAD alerts. For each DAD, percentage hits (alert with BG ≤ 5.0 or ≥ 11.1 mmol/L; ≤90 or ≥200 mg/dl), percentage misses (no alert with BG out of range), and percentage false alarms (alert with BG in range) were computed. Sensitivity, specificity, positive likelihood ratio (PLR), and true positive rates were also calculated.RESULTS: Overall comparison of DAD Hits to Misses yielded significantly more Hits for both low and high BG. Total sensitivity was 57.0%, with increased sensitivity to low BG (59.2%) compared to high BG (56.1%). Total specificity was 49.3% and PLR = 1.12. However, high variability in accuracy was observed across DADs, with low BG sensitivity ranging from 33% to 100%. Number of DADs achieving ≥ 60%, 65% and 70% true positive rates was 71%, 50% and 44%, respectively.CONCLUSIONS: DADs may be able to detect out-of-range BG, but variability across DADs is evident. Larger trials are needed to further assess DAD accuracy and to identify factors influencing the complexity of DAD accuracy in BG detection.