Eleni Linos

speaker

36 appearances 1 recordings 1 series first heard Mar 2020 last heard Mar 2020

Eleni Linos’s voice in public audio — every appearance, attributed to the second.

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Talk Evidence · Talk Evidence - testing under the microscope and opioid prescription · 20 Mar 2020 podcast

So there's two things.

We do a test to see if you have this diagnosis.

And in this case, we're doing that with A1C.

So for instance, if you were to get an A1C back of, say, 6.7%, that's kind of

sort of maybe diabetes, but not really diabetes, depending on what threshold you use.

But around that test is a plus and minus.

And so in our paper, when we talked about that, the plus minus is anywhere between sort of 6% to 10%, or it could be as high as 11% to 20%, depending on

you know, who you're testing and so on.

And so if you just, let's just use the, as a 10% number as a plus minus.

So if you, let's say you get an A1C back of seven, you can, all you can really say is it's probably somewhere between 6.3 or maybe 6.5 and maybe 7.5.

So given that the, you know, the threshold for pre-diabetes versus diabetes versus in quotation marks, normal,

is about a spread of about one and one and a half, it makes it very tricky to, you can remeasure it again and be way outside of, you can go from being a pre-diabetic to a diabetic or normal just based on that biologic variation.

And so what we try to do in that paper is give the example of how to think about it.

And I think one of the key things is it shows that there's two problems here.

The lab test is a problem.

but also are being fixated on a specific threshold, which is very arbitrary.

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