在2型糖尿病中推导基于年化索赔的主要不良心血管事件估计器
Rozalina G McCoy1,2,3,4, Kavya Sindhu Swarna4,5, Yihong Deng4,5
1Division of Endocrinology, Diabetes, & Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
JACC. Advances
|June 28, 2024
概括
一个新的模型使用现有索赔数据预测2型糖尿病患者1年重大心血管不良事件 (MACE) 风险. 该工具有助于风险分层和临床试验招聘.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 医疗信息学 医疗信息学
背景情况:
- 主要不良心血管事件 (MACE) 对患有2型糖尿病的成年人构成重大威胁.
- 现有的MACE预测模型存在局限性,包括数据可用性,狭窄的焦点和长的预测时间.
研究的目的:
- 开发和验证一个基于索赔的模型,用于预测2型糖尿病患者1年的MACE风险.
主要方法:
- 这项研究利用了大量患有2型糖尿病的成年人 (2014-2021) 的医疗和药房声明.
- 基于年化索赔的MACE估计器 (ACME) 模型是使用30个共变量的考克斯比例危险模型来推导的.
- 在ACME模型上进行了内部验证.
主要成果:
- 这项研究包括超过660万患有2型糖尿病的成年人.
- ACME模型表现出良好的表现,一致性指数为0.74.
- 预测的1年MACE风险差异很大,中位数为3.4%.
结论:
- 该ACME模型提供了一种可靠的方法,用于估计短期MACE风险,使用常规可用的索赔数据.
- ACME可以支持卫生系统和支付人进行风险分层,并确定临床试验的参与者.
- 该模型对于使用真实世界的数据进行风险分层观察性研究是有价值的.
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