Comparing the Ability of Two Comprehensive Clinical Staging Systems to Predict Mortality: EOSS and CMDS

Area of Science:

• Clinical research
• Public health
• Epidemiology

Background:

• Obesity is a major public health concern associated with increased mortality risk.
• Accurate clinical staging systems are crucial for assessing patient prognosis and guiding interventions.
• The Edmonton Obesity Staging System (EOSS) and Cardiometabolic Disease Staging (CMDS) are two such systems.

Purpose of the Study:

• To compare the discriminative and predictive abilities of EOSS and CMDS for all-cause mortality.
• To evaluate the potential clinical utility of each staging system.

Main Methods:

• Utilized data from the National Health and Nutrition Examination Survey for nonpregnant adults aged 40-75 years.
• Assessed predictive and discriminative ability using pseudo-R-squared and C-statistics.
• Calculated median years of life lost for different scores within each system.

Main Results:

• CMDS demonstrated statistically significantly greater predictive and discriminative ability for all-cause mortality compared to EOSS.
• The differences in predictive ability, measured by pseudo-R-squared and C-statistics, favored CMDS.
• CMDS assigned higher median years of life lost across its risk strata compared to EOSS.

Conclusions:

• CMDS exhibits superior predictive and discriminative performance for mortality in adults aged 40-75 compared to EOSS.
• CMDS may possess greater clinical utility due to its simpler risk stratification approach.
• Further research is warranted to fully understand the clinical relevance and utility of CMDS.