Validation and Comparison of 10‐Year Cardiovascular Risk Prediction Models in Two Chinese Prospective Cohorts: The General Population and Patients With Type 2 Diabetes
Authors' conclusion
Widely used 10-year CVD risk models showed acceptable or modest discrimination but substantial miscalibration in Chinese populations, especially among adults with type 2 diabetes.
Study context
- Population
- Chinese general population and adults with T2D, without baseline cardiovascular disease (CVD) (and without baseline diabetes in China Kadoorie Biobank (CKB)) or missing predictors
- Participants
- 42,937 vs 14,125
- Comparison
- CKB-CVD, Globorisk, Framingham General CVD, WHO 2019 (both cohorts) and SCORE2-Diabetes (T2D cohort), original vs recalibrated
- CKBn = 42,937
- Jiangsu Biobank for the Prevention and Control of Diabetes (JBPCD)n = 14,125
- Outcome
- Performance of 10-year CVD risk models (ischemic heart disease or stroke): discrimination (IPCW C-statistic), calibration (E/O ratio), Brier score
- Follow-up
- 10 years
Methodological detailsexternal validation, recalibration, 10-year inverse probability of censoring weighting (IPCW) C-statistic, E/O ratio and Brier score
- External validation
- Recalibration
- 10-year IPCW C-statistic
- E/O ratio and Brier score
Performance
As reported in the abstract
C-statistic, general population cohort
0.723-0.778
C-statistic, type 2 diabetes cohort
0.584-0.629
Original models poorly calibrated: systematic overprediction, E/O in general population cohort
1.47-3.78
Original models poorly calibrated: heterogeneous miscalibration, E/O in type 2 diabetes cohort
0.32-2.70
Further findings
Ischemic heart disease or stroke events and 10-year risk · median follow-up 11.96 years (general population cohort) and 10.03 years (type 2 diabetes cohort)
- Events, general population cohort
- 3740
- 10-year risk, general population cohort
- 6.04%
- Events, type 2 diabetes cohort
- 2794
- 10-year risk, type 2 diabetes cohort
- 19.72%
High-risk classification (≥20% predicted 10-year risk) by recalibrated CKB-CVD, type 2 diabetes cohort
- Classified as high risk
- 48.4%
- Observed 10-year risk among those classified high risk
- 25.7%
Original publication
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