Comparison of prediction models for cardiovascular and mortality risk in people with type 2 diabetes: An external validation in 23 685 adults included in the UK Biobank
Authors' conclusion
The RECODe model led to better risk estimations in this predominantly White European population. Further validation is needed in non-Western populations to assess generalizability to other populations.
Study context
- Population
- Adults with T2D in the UK Biobank, aged 40–71 years, 63.5% male
- Participants
- 23,685 adults269,430 person-years
- Comparison
- Cardiovascular and mortality risk prediction models
- Outcome
- Discrimination and calibration for mortality, cardiovascular mortality, congestive HF, MI, stroke and ischaemic heart disease
- Follow-up
- Median 11.89 years
Methodological details19 cardiovascular risk scores from seven models identified from systematic reviews, UK Biobank data 2006–2021
- 19 cardiovascular risk scores from seven models identified from systematic reviews
- UK Biobank data 2006–2021
Performance
As reported in the abstract
Discrimination (c-index)
| Test or model | C-index all-cause mortality | C-index congestive HF | C-index MI | C-index stroke | C-index cardiovascular mortality |
|---|---|---|---|---|---|
| RECODe | 0.67 (95% CI 0.65-0.69) | 0.71 (95% CI 0.69-0.72) | 0.67 (95% CI 0.65-0.68) | 0.65 (95% CI 0.62-0.68) | — not stated in the abstract |
| UKPDS OM2 | 0.67 (95% CI 0.66-0.69) | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | 0.71 (95% CI 0.70-0.73) |
C-index all-cause mortality
RECODe0.67 (95% CI 0.65-0.69)
UKPDS OM20.67 (95% CI 0.66-0.69)
C-index congestive HF
RECODe0.71 (95% CI 0.69-0.72)
UKPDS OM2— not stated in the abstract
C-index MI
RECODe0.67 (95% CI 0.65-0.68)
UKPDS OM2— not stated in the abstract
C-index stroke
RECODe0.65 (95% CI 0.62-0.68)
UKPDS OM2— not stated in the abstract
C-index cardiovascular mortality
RECODe— not stated in the abstract
UKPDS OM20.71 (95% CI 0.70-0.73)
— not stated in the abstract
- All models: low-to-moderate discrimination (c-indices)
- 0.50-0.71
Further findings
Performance by subgroup
- Models performed better for younger participants and somewhat better for non-White ethnicities
- Models developed from non-Western datasets performed worse in the UK-based validation set
Original publication
Comparison of prediction models for cardiovascular and mortality risk in people with type 2 diabetes: An external validation in 23 685 adults included in the UK Biobank. Diabetes Obes Metab. Published 31 January 2024. doi:10.
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