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New Zealand Diabetes Cohort Study cardiovascular risk score for people with Type 2 diabetes: validation in the PREDICT cohort.
J Prim Health Care. 2012 Sep 01; 4(3):181-8.JP

Abstract

INTRODUCTION

New Zealand (NZ) guidelines recommend treating people for cardiovascular disease (CVD) risk on the basis of five-year absolute risk using a NZ adaptation of the Framingham risk equation. A diabetes-specific Diabetes Cohort Study (DCS) CVD predictive risk model has been developed and validated using NZ Get Checked data.

AIM

To revalidate the DCS model with an independent cohort of people routinely assessed using PREDICT, a web-based CVD risk assessment and management programme.

METHODS

People with Type 2 diabetes without pre-existing CVD were identified amongst people who had a PREDICT risk assessment between 2002 and 2005. From this group we identified those with sufficient data to allow estimation of CVD risk with the DCS models. We compared the DCS models with the NZ Framingham risk equation in terms of discrimination, calibration, and reclassification implications.

RESULTS

Of 3044 people in our study cohort, 1829 people had complete data and therefore had CVD risks calculated. Of this group, 12.8% (235) had a cardiovascular event during the five-year follow-up. The DCS models had better discrimination than the currently used equation, with C-statistics being 0.68 for the two DCS models and 0.65 for the NZ Framingham model.

DISCUSSION

The DCS models were superior to the NZ Framingham equation at discriminating people with diabetes who will have a cardiovascular event. The adoption of a DCS model would lead to a small increase in the number of people with diabetes who are treated with medication, but potentially more CVD events would be avoided.

Authors+Show Affiliations

Department of General Practice and Primary Health Care, The University of Auckland, PB 92019, Auckland, New Zealand. t.robinson@auckland.ac.nzNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

22946065

Citation

Robinson, Tom, et al. "New Zealand Diabetes Cohort Study Cardiovascular Risk Score for People With Type 2 Diabetes: Validation in the PREDICT Cohort." Journal of Primary Health Care, vol. 4, no. 3, 2012, pp. 181-8.
Robinson T, Elley CR, Wells S, et al. New Zealand Diabetes Cohort Study cardiovascular risk score for people with Type 2 diabetes: validation in the PREDICT cohort. J Prim Health Care. 2012;4(3):181-8.
Robinson, T., Elley, C. R., Wells, S., Robinson, E., Kenealy, T., Pylypchuk, R., Bramley, D., Arroll, B., Crengle, S., Riddell, T., Ameratunga, S., Metcalf, P., & Drury, P. L. (2012). New Zealand Diabetes Cohort Study cardiovascular risk score for people with Type 2 diabetes: validation in the PREDICT cohort. Journal of Primary Health Care, 4(3), 181-8.
Robinson T, et al. New Zealand Diabetes Cohort Study Cardiovascular Risk Score for People With Type 2 Diabetes: Validation in the PREDICT Cohort. J Prim Health Care. 2012 Sep 1;4(3):181-8. PubMed PMID: 22946065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - New Zealand Diabetes Cohort Study cardiovascular risk score for people with Type 2 diabetes: validation in the PREDICT cohort. AU - Robinson,Tom, AU - Elley,C Raina, AU - Wells,Sue, AU - Robinson,Elizabeth, AU - Kenealy,Tim, AU - Pylypchuk,Romana, AU - Bramley,Dale, AU - Arroll,Bruce, AU - Crengle,Sue, AU - Riddell,Tania, AU - Ameratunga,Shanthi, AU - Metcalf,Patricia, AU - Drury,Paul L, Y1 - 2012/09/01/ PY - 2012/9/5/entrez PY - 2012/9/5/pubmed PY - 2012/12/10/medline SP - 181 EP - 8 JF - Journal of primary health care JO - J Prim Health Care VL - 4 IS - 3 N2 - INTRODUCTION: New Zealand (NZ) guidelines recommend treating people for cardiovascular disease (CVD) risk on the basis of five-year absolute risk using a NZ adaptation of the Framingham risk equation. A diabetes-specific Diabetes Cohort Study (DCS) CVD predictive risk model has been developed and validated using NZ Get Checked data. AIM: To revalidate the DCS model with an independent cohort of people routinely assessed using PREDICT, a web-based CVD risk assessment and management programme. METHODS: People with Type 2 diabetes without pre-existing CVD were identified amongst people who had a PREDICT risk assessment between 2002 and 2005. From this group we identified those with sufficient data to allow estimation of CVD risk with the DCS models. We compared the DCS models with the NZ Framingham risk equation in terms of discrimination, calibration, and reclassification implications. RESULTS: Of 3044 people in our study cohort, 1829 people had complete data and therefore had CVD risks calculated. Of this group, 12.8% (235) had a cardiovascular event during the five-year follow-up. The DCS models had better discrimination than the currently used equation, with C-statistics being 0.68 for the two DCS models and 0.65 for the NZ Framingham model. DISCUSSION: The DCS models were superior to the NZ Framingham equation at discriminating people with diabetes who will have a cardiovascular event. The adoption of a DCS model would lead to a small increase in the number of people with diabetes who are treated with medication, but potentially more CVD events would be avoided. SN - 1172-6156 UR - https://www.unboundmedicine.com/medline/citation/22946065/New_Zealand_Diabetes_Cohort_Study_cardiovascular_risk_score_for_people_with_Type_2_diabetes:_validation_in_the_PREDICT_cohort_ L2 - http://www.diseaseinfosearch.org/result/2243 DB - PRIME DP - Unbound Medicine ER -