ニュージーランドのプライマリケアにおける14000人以上のがん生存者における心血管疾患リスク予測方程式の性能:検証研究
Essa Tawfiq1, Vanessa Selak1, J Mark Elwood1
1School of Population Health, University of Auckland, Auckland, New Zealand.
Lancet (London, England)
|January 26, 2023
まとめ
ニュージーランドの心血管疾患リスク方程式は 癌の生存者におけるリスクを 合理的に予測します 更に改善は,がん特異的な要因と,より優れた臨床ツールのための競合するリスクを含んでいるかもしれません.
科学分野:
- 心臓病科
- 腫瘍学
- 流行病学について
背景:
- 癌を生き延びた人は 心血管疾患 (CVD) のリスクが高くなります
- 既存のニュージーランドのCVDリスク予測方程式は一般集団で検証されています.
- この研究は ニュージーランドの癌の生存者に対して これらの方程式を評価しています
研究 の 目的:
- 癌の生存者におけるニュージーランドのCVDリスク予測方程式のパフォーマンスを評価する.
- 現在の方程式がこの集団に対して臨床的に適切かどうかを判断する.
- 癌の生存者におけるCVDリスク予測を改善するための潜在的な分野を特定する.
主な方法:
- PREDICTコホート研究 (n=14,263) のデータを活用し,少なくとも2年前に診断されたがんの生存者を含む.
- 性別特有のCVDリスク方程式の評価 (観察された対予測されたリスク) と差別 (ハレルのC統計)
- この方程式には 年齢,民族,貧困,家族歴,喫煙, AF,糖尿病,血圧,コレステロールの比率,薬が含まれています
主要な成果:
- 方程式は合理的な校正を証明し,観察されたリスクの予測を最大3.2%下回した.
- 臨床リスク群では,低リスク群では予測不足が< 2%,高リスク群ではわずかな予測過剰が (2. 2- 3. 3%) であった.
- 男子では0.67,女性では0.73のHarrell's C統計で,差別は許容される.
結論:
- ニュージーランドのCVDリスク予測方程式は,がんの生存者にとって合理的な臨床的有用性を提供します.
- がん特異変数と競合するリスクを組み込むような改良により,予測の精度がさらに改善されます.
- この結果は,ニュージーランドでがんを生き延びた患者の心血管疾患のリスクを管理するための臨床的ツールとしてこれらの方程式の使用を支持しています.
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