Background The aim of the present study was to recalibrate the effectiveness of Indian Diabetes Risk Score (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistic screening of Diabetes Mellitus (DM) and Hypertension (HT) among the people attending health centres, and estimating the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) among them using WHO/ISH charts. Methods All the people aged ≥ 30 years attending the health centers were screened for DM and HT. Weight, height, waist circumference, and hip circumferences were measured, and BMI and Waist-Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score, and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden’s index were calculated for different cut-offs of IDRS and CBAC scores. Results A total of 942 participants were included for the screening, out of them, 9.2% (95% CI: 7.45–11.31) were diagnosed with DM for the first time. Hypertension was detected among 25.7% (95% CI: 22.9–28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score > 4. As much as 26.1% were at moderate to higher risk (≥ 10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58–0.70), with 67.1% SN and 55.2% SP (Youden’s Index 0.22). While the AUC for CBAC was 0.59 (0.53–0.65). For hypertension both the AUCs were 0.66 (0.62–0.71) and 0.63 (0.59–0.67), respectively. Conclusions IDRS was found to have the maximum AUC and sensitivity thereby demonstrating its usefulness as compared to other tools for screening of both diabetes and hypertension. It thus has the potential to expose the hidden NCD iceberg. Hence, we propose IDRS as a useful tool in screening of Diabetes and Hypertension in rural India.

Background: The present study was conducted to recalibrate the effectiveness of Indian Diabetes Risk Scores (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistically screening for Diabetes Mellitus (DM) and Hypertension (HT) among the patients attending health centres, and to estimate the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) using WHO/ISH chartMethods: All the people of age ≥30 years attending the health centers were screened for DM and HT. Weight, height, and waist and hip circumferences were measured and BMI and Waist Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden’s index were calculated for different cut-offs of IDRS and CBAC scores.Results: A total of 942 participants were included for the screening, out of them, 6.42 % (95% CI: 4.92-8.20) were diagnosed with DM. Hypertension was detected among 25.7% (95% CI: 22.9-28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score >4. As much as 26.1% were at moderate to higher risk (≥10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58-0.70), with 67.1% SN and 55.2% SP (Youden's Index= 0.22). While the AUC for CBAC was 0.59 (0.53-0.65). For hypertension the both the AUCs were 0.66 (0.62-0.71) and 0.63 (0.59-0.67), respectively.Conclusions: Instead of CBAC, the present study emphasizes the usefulness of IDRS as an excellent tool for screening for both DM and HT. This is the time to expose the hidden part of the NCDs iceberg by having high sensitivity of non-invasive instruments (like IDRS), so, we propose a cut-off value of 50 for the IDRS to screen for diabetes in the rural Indian population.