| Title: |
Performance of cardiovascular disease risk scores in people diagnosed with type 2 diabetes: External validation using data from the National Scottish diabetes register |
| Authors: |
Read, SH; Van Diepen, M; Colhoun, HM; Halbesma, N; Lindsay, RS; McKnight, JA; McAllister, DA; Pearson, ER; Petrie, JR; Philip, S; Sattar, N; Woodward, M; Wild, SH |
| Source: |
urn:ISSN:0149-5992 ; urn:ISSN:1935-5548 ; Diabetes Care, 41, 9, 2010-2018 |
| Publisher Information: |
American Diabetes Association |
| Publication Year: |
2018 |
| Collection: |
UNSW Sydney (The University of New South Wales): UNSWorks |
| Subject Terms: |
32 Biomedical and Clinical Sciences; 4202 Epidemiology; 4203 Health Services and Systems; 4206 Public Health; 42 Health Sciences; 3202 Clinical Sciences; Heart Disease; Aging; Health Disparities; Diabetes; Cardiovascular; Health Disparities and Racial or Ethnic Minority Health Research; Prevention; Metabolic and endocrine; 3 Good Health and Well Being; Adult; Aged; 80 and over; Cardiovascular Diseases; Cohort Studies; Diabetes Mellitus; Type 2; Diabetic Angiopathies; Diagnostic Techniques; Endocrine; Female; Humans; Male; Middle Aged; Prognosis |
| Description: |
OBJECTIVE: To evaluate the performance of five cardiovascular disease (CVD) risk scores developed in diabetes populations and compare their performance to QRISK2. RESEARCH DESIGN AND METHODS: A cohort of people diagnosed with type 2 diabetes between 2004 and 2016 was identified from the Scottish national diabetes register. CVD events were identified using linked hospital and death records. Five-year risk of CVD was estimated using each of QRISK2, ADVANCE (Action in Diabetes and Vascular disease: preterAx and diamicroN-MR Controlled Evaluation), Cardiovascular Health Study (CHS), New Zealand Diabetes Cohort Study (NZ DCS), Fremantle Diabetes Study, and Swedish National Diabetes Register (NDR) risk scores. Discrimination and calibration were assessed using the Harrell C statistic and calibration plots, respectively. RESULTS: The external validation cohort consisted of 181, 399 people with type 2 diabetes and no history of CVD. There were 14,081 incident CVD events within 5 years of follow-up. The 5-year observed risk of CVD was 9.7% (95% CI 9.6, 9.9). C statistics varied between 0.66 and 0.67 for all risk scores. QRISK2 overestimated risk, classifying 87% to be at high risk for developing CVD within 5 years; ADVANCE underestimated risk, and the Swedish NDR risk score calibrated well to observed risk. CONCLUSIONS: None of the risk scores performed well among people with newly diagnosed type 2 diabetes. Using these risk scores to predict 5-year CVD risk in this population may not be appropriate. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
https://hdl.handle.net/1959.4/107345 |
| DOI: |
10.2337/dc18-0578 |
| Availability: |
https://hdl.handle.net/1959.4/107345; https://unsworks.unsw.edu.au/bitstreams/5e06d370-e6d5-4ab9-8e9f-5bd18c28e682/download; https://doi.org/10.2337/dc18-0578 |
| Rights: |
open access ; https://purl.org/coar/access_right/c_abf2 ; CC-BY ; https://creativecommons.org/licenses/by/4.0/ ; free_to_read |
| Accession Number: |
edsbas.9A4F7C8 |
| Database: |
BASE |