Performance evaluation of a self-administered home oral glucose tolerance test kit in a controlled clinical research setting.

AIM: To evaluate the performance of the current, pre-production version of a novel home oral glucose tolerance test (Home OGTT) device when administered by trained research nurses, compared with a reference laboratory glucose analyser and a second laboratory analyser, incorporating a sample processing delay to simulate normal practice. METHODS: One hundred women (aged 19-48 years), with and without known glucose intolerance were recruited. Following an overnight fast, participants attended for a 75-g OGTT. A fasting capillary sample was applied to the Home OGTT device with a corresponding venous sample collected and measured immediately on the reference YSI 2300 stat plus analyser, and following a 1-h delay on the Randox Daytona Plus analyser. The sampling process was repeated 2 h after the oral glucose load. RESULTS: Some 97% of tested devices gave complete data for analysis. Good agreement was observed between the reference glucose analyser and the Home OGTT device, with the Home OGTT device displaying a small negative bias (-0.18 mmol/l, -1.75 to 1.39 mmol/mol; -1.0%, -26.4% to 24.5%; absolute and relative mean, 95% limits of agreement). When classified as normal glucose tolerant or glucose intolerant, the Home OGTT device showed 100% and 90% sensitivity, and 99% and 99% specificity using fasting plasma glucose and 2-h glucose respectively. Similar sensitivity (100% and 100%) and specificity (96% and 99%) for fasting plasma glucose and 2-h glucose were observed using the secondary analyser. CONCLUSIONS: The novel Home OGTT device was reliable and easy to use and showed excellent agreement with two separate laboratory analysers. The Home OGTT offers potential as an effective alternative for clinic-based OGTT testing.

The role of fertility and population in economic growth: empirical research from aggregate cross-national data.

PIP: At current growth rates, world population will double from 5 billion in 1987 to 10 billion by 2030. This doubling time is extremely short compared to the 1700 years spanned over which world population doubled to 600 million from its 1 A.D. size of 300 million. The rate of population growth has fallen since its 1970 peak, but the momentum of growth and the absolute increase in population numbers remain of staggering population. Two recently improved sets of cross-country panel data from Summers and Heston, and UN World Population Prospects are combined in a re-examination of the effects of population growth and fertility on economic growth. A 107-country panel data set is employed for 1960-1985. Review indicates that high birth rates appear to reduce economic growth through investment effects and possibly capital dilution, but classic resource dilution was not observed. Birth rate declines have a strong medium-term positive impact on per capita income growth through labor supply or dependency effects.^ieng