基于实验室和非实验室的心血管风险预测工具在印度农村地区的比较
Mulugeta Molla Birhanu1, Ayse Zengin1, Roger G Evans2,3
1Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
Tropical medicine & international health : TM & IH
|December 11, 2024
概括
基于非实验室的心血管风险工具与印度农村的基于实验室的方法有很大的一致性. 然而,对于糖尿病患者来说,它们的准确性可能会降低.
科学领域:
- 心血管流行病学心血管流行病学
- 公共卫生 公共卫生
- 低收入和中等收入国家的健康公平.
背景情况:
- 基于非实验室的心血管风险预测工具在资源有限的环境中提供了可行的替代方案.
- 关于它们与基于实验室的工具的比较有效性的数据有限.
研究的目的:
- 为了比较基于实验室和非实验室的心血管风险预测工具的风险估计.
- 评估这些工具在低收入和中等收入国家之间的一致性.
主要方法:
- 印度农村 (2012-2015) 的跨部门研究,涉及2847名参与者 (40-74岁).
- 使用弗雷明汉风险评分 (FRS),世界卫生组织风险评分 (WHO-RS) 和Globorisk.com进行10年绝对风险的比较.
- 使用普通最小产品回归和二次加权kappa评估的协议.
主要成果:
- 超过80%的参与者被基于实验室和非实验室的工具分为相同的风险范围.
- 观察到强烈的共识,WHO-RS显示最高 (斜率=0.96, κw=0.93) 和FRS显示最低 (斜率=0.84, κw=0.88).
- 在女性和没有高胆固醇血症或高血压的人群中,一致性更高,但在糖尿病患者中较差.
结论:
- 基于非实验室的风险预测工具 (弗雷明汉姆,WHO-RS,Globorisk) 在印度农村地区的实验室方法相比表现良好.
- 这些工具在糖尿病人群中风险分层方面可能存在局限性.
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