在现实环境中对2型糖尿病患者心血管结果的风险预测方程的调整:采用共同数据模型方法的跨机构研究
Chun-Ting Yang1,2, Kah Suan Chong1, Chi-Chuan Wang3,4,5
1Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Cardiovascular diabetology
|July 10, 2024
概括
这项研究使用电子健康记录调整了台湾2型糖尿病患者心肌梗塞,中风和心力衰竭的风险预测方程. 再校准的方程显示了令人满意的校准,改善了心血管风险预测.
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:
- 心血管疾病仍然是2型糖尿病患者发病和死亡的主要原因.
- 现有的风险预测方程可能无法准确地反映不同人群中的心血管风险.
- 电子健康记录 (EHR) 为在现实环境中适应和验证风险预测模型提供了宝贵的资源.
研究的目的:
- 调整和验证现有的心肌梗塞 (MI),中风和心力衰竭 (HF) 的风险预测方程.
- 评估UKPDS-OM2,RECODe和CHIME模型在台湾2型糖尿病人群中的性能,使用跨机构EHR数据.
- 重新校准方程,以提高它们在预测特定人群中心血管事件的准确性.
主要方法:
- 利用了来自台湾两个主要医疗中心 (NCKUH和NTUH) 的EHR数据,采用了共同的数据模型方法.
- 执行了UKPDS-OM2,RECODe和CHIME风险方程的外部验证,使用歧视 (AUROC) 和校准 (GND测试) 度量.
- 通过调整基线危险来提高预测准确度,重新校准了校准不满意的方程.
主要成果:
- 与UKPDS-OM2和RECODe模型相比,CHIME风险方程显示了可接受的歧视 (AUROC:0.71-0.79) 和优异的校准.
- 在重新校准后,所有CHIME风险方程 (针对MI,中风和HF) 在NCKUH和NTUH人群中都实现了令人满意的校准 (GND测试的p值≥0.05).
- 经过验证和重新校准的方程提供了对台湾2型糖尿病患者心血管事件的可靠风险预测.
结论:
- 开发并验证了针对台湾2型糖尿病患者量身定制的MI,中风和HF的准确风险预测方程.
- 提出了适应和重新校准不同医疗机构风险预测方程的强有力的框架.
- 这些发现有助于改善台湾2型糖尿病患者心血管风险管理策略.
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