Prediction of 10-year vascular risk in patients with diabetes: The AD-ON risk score

on behalf of the ADVANCE Collaborative Group

研究成果: Contribution to journalArticle査読

17 被引用数 (Scopus)

抄録

Aims: To formulate a combined cardiovascular risk score in diabetes that could be useful both to physicians and healthcare funders. Methods: Data were derived from the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation Observational (ADVANCE-ON) study, a randomized controlled trial (mean duration 5years) with a post-randomization follow-up (mean 4.9years), that included 11140 high-risk patients with diabetes. The outcome analysed was the occurrence of either fatal or non-fatal macrovascular or renal disease. A Cox regression model was used to determine weightings in the risk score. The resultant score was recalibrated to each of three major global regions, as covered by the ADVANCE-ON study. Results: Over a median of 9.9years, 1145 patients experienced at least one component of the combined outcome event. The resultant score, the AD-ON risk score, incorporated 13 demographic or clinical variables. Its discrimination was modest [c-statistic=0.668 (95% confidence interval 0.651, 0.685)] but its calibration was excellent (predicted and observed risks coincided well, within disparate global regions). In terms of the integrated discrimination improvement index, its performance was marginally superior, over a 10-year risk horizon, to existing risk scores in clinical use, from a restricted version of the same data, for macrovascular and renal disease separately. Conclusions: The AD-ON risk score has advantages over the existing vascular risk scores in diabetes that used data from the original ADVANCE trial, which treat macrovascular and renal diseases separately. These advantages include its simplicity of use and global application.

本文言語英語
ページ(範囲)289-294
ページ数6
ジャーナルDiabetes, Obesity and Metabolism
18
3
DOI
出版ステータス出版済み - 3 1 2016

All Science Journal Classification (ASJC) codes

  • 内科学
  • 内分泌学、糖尿病および代謝内科学
  • 内分泌学

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