Predictive ability of the SCORE Belgium risk chart for cardiovascular mortality
Predictive ability of the SCORE Belgium risk chart for cardiovascular mortality
复制标题
DOI：
10.1016/j.ijcard.2009.03.101
复制
发表时间：
2010-09-03
影响因子：
3.5
通讯作者：
De Backer, Guy
中科院分区：
文献类型：
--
作者：
De Bacquer, Dirk;De Backer, Guy
背景：在心血管疾病预防的背景下，识别心血管疾病高危人群是至关重要的。风险评估的准确性和精确性是基本属性。我们开发了一个校准的SCORE风险图表（系统性冠状动脉风险评估），用于计算发生致命性心血管事件的绝对10年概率，适用于比利时的国家死亡率统计和风险因素分布，并严格评估其预测准确性。方法：我们的SCORE比利时风险图表使用6212个非参与80年代进行的前瞻性队列研究的无CHD的糖尿病男性和女性（比利时大学间营养与健康研究）。使用卡方和Hosmer-Lemeshow统计研究了整个风险传播中预测和观察到的CVD死亡人数之间的一致性。根据Harrell的c-statistics.Results：在10年期间，观察到274例CVD死亡，而重新校准的风险图预测263起事件的风险估计的判别力进行了评估。SCORE比利时风险图在预测风险的整个范围内显示出非常好的准确性（Hosmer-Lemeshow：P=0.14）。ROC分析显示，在标记未来致命性心血管疾病病例方面具有出色的区分能力，c统计量为0.86。10年心血管死亡的概率的5%阈值产生了最佳的平衡的灵敏度和特异性conclusions：SCORE比利时风险图证明是非常适合作为一个准确和精确的估计工具，在比利时心血管风险的评估。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。
Background: The identification of persons at high cardiovascular risk is of primary importance in the context of cardiovascular prevention. Accuracy and precision of risk assessment are essential properties. We developed a calibrated SCORE risk chart (Systematic COronary Risk Evaluation) for calculating the absolute 10-year probability of developing a fatal cardiovascular event, adapted to national mortality statistics and risk factor distributions in Belgium and critically evaluated its predictive accuracy.Methods: Our SCORE Belgium risk chart was validated using data from 6212 non-diabetic men and women free of CHD participating in a prospective cohort study carried out in the eighties (Belgian Interuniversity Research on Nutrition and Health). Agreement between numbers of predicted and observed CVD deaths across the entire spread of risk was studied using chi-square and Hosmer-Lemeshow statistics. Discrimatory power of risk estimates was evaluated according to Harrell's c-statistic.Results: During the period of 10 years, 274 CVD deaths were observed while the recalibrated risk chart predicted 263 events. The SCORE Belgium risk chart showed very good accuracy over the complete range of predicted risk (Hosmer-Lemeshow: P=0.14). ROC analysis revealed excellent discriminatory power in labelling future cases of fatal cardiovascular disease with a c-statistic of 0.86. The 5% threshold for the probability of 10-year cardiovascular death yielded an optimal balance of sensitivity and specificity.Conclusions: The SCORE Belgium risk chart proves to be well suited as an accurate and precise estimation tool for the assessment of cardiovascular risk in Belgium. (C) 2009 Elsevier Ireland Ltd. All rights reserved.