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Screening Methods for Diagnosing Cystic Fibrosis-Related Diabetes: A Network Meta-Analysis of Diagnostic Accuracy Studies

Lookup NU author(s): Professor James Shaw



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021 by the authors. Licensee MDPI, Basel, Switzerland.Background: Cystic fibrosis-related diabetes (CFRD) has become more common due to higher life expectancy with cystic fibrosis. Early recognition and prompt treatment of CFRD leads to improved outcomes. Methods: We performed a network meta-analysis (NMA) in order to identify the most valuable diagnostic metrics for diagnosing CFRD out of available screening tools (index test), using the oral glucose tolerance test as a reference standard. Pooled sensitivity (Se), specificity (Sp), and superiority indices were calculated and used to rank the index tests. Results: A total of 31 articles with 25 index tests were eligible for inclusion. Two-day, continuous glucose monitoring (CGM) ranked the highest (Se: 86% Sp: 76%), followed by glucose measurement from blood capillary samples (Se: 70%, Sp: 82%) and three-day CGM (Se: 96%, Sp: 56%). When we compared the CGM of different durations, two-day CGM performed best (Se: 88%, Sp: 80%), followed by three-day (Se: 96%, Sp: 59%) and six-day CGM (Se: 66%, Sp: 79%). Conclusions: Considering its overall performance ranking, as well as the high sensitivity, two-day CGM appears to be a promising screening test for CFRD.

Publication metadata

Author(s): Izsak VD, Soos A, Szakacs Z, Hegyi P, Juhasz MF, Varannai O, Martonosi AR, Foldi M, Kozma A, Vajda Z, Shaw JAM, Parniczky A

Publication type: Review

Publication status: Published

Journal: Biomolecules

Year: 2021

Volume: 11

Issue: 4

Online publication date: 31/03/2021

Acceptance date: 29/03/2021

ISSN (electronic): 2218-273X

Publisher: MDPI AG


DOI: 10.3390/biom11040520