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Validating the UK prospective diabetes study outcome model 2 using data of 94,946 Israeli patients with type 2
Xiaohui Zhuo1, Cheli Melzer Cohen2, Jieling Chen1
1Merck & Co., Inc., Kenilworth, NJ, USA.
Aims:
To externally validate the United Kingdom Prospective Diabetes Study (UKPDS) Outcome Model 2 (OM2) in contemporary Israeli patient populations.
Methods:
De-identified patient data on demographics, time-varying risk factors, and clinical events of newly diagnosed type 2 diabetes patients were extracted from the Maccabi Healthcare Services (MHS) diabetes registry over years 2000-2013. Depending on the baseline risk, patients were categorized into low-risk and intermediate-risk groups. In addition to assessing discriminatory performance, the predicted and observed 15-year cumulative incidences of diabetes complications and death were compared among all patients and for the two risk-groups.
Results:
The discriminatory capability of OM2 was moderate to good, C-statistic ranging 0.71-0.95. The model overpredicted the risk for MI, blindness and death (Predicted/Observed events (P/O: 1.32-2.31)), and underpredicted the risk of IHD (P/O: 0.5). In patients with a low baseline risk, overpredictions were even more pronounced. OM2 performed well in predicting renal failure and ulcer risk in patients with a low risk but predicted well the risk of death, stroke, CHF, and amputation in patients with an intermediate risk.
Conclusion:
OM2 demonstrated good to moderate discrimination capability for predicting diabetes complications and mortality risks in Israeli diabetes population. The prediction performance differed between patients with different baseline risks.
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