使用SCORE2与风险图或在线计算器:对模型性能,治疗资格和心血管疾病预防的影响
Steven H J Hageman1, Stephen Kaptoge2, Mari N Gynnild3,4,5
1Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
European heart journal. Quality of care & clinical outcomes
|October 10, 2025
概括
SCORE2风险图表高估了心血管疾病风险,导致更多人有资格接受预防性治疗. 在线计算器提供了更好的风险预测准确性和歧视.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 风险评估 风险评估
背景情况:
- 欧洲指南使用SCORE2模型进行心血管疾病 (CVD) 风险评估,以指导预防性治疗.
- 风险估计可以通过风险图表或在线计算器进行,精度可能有差异.
研究的目的:
- 为了比较SCORE2风险评估的精度和治疗分类,使用风险图表与在线计算器对比.
- 评估不同风险估计方法对治疗资格和事件预防的影响.
主要方法:
- 分析了来自英国 (低风险) 和中欧/东欧 (高/非常高风险) 的大型队列研究 (n=989,355).
- 使用风险图表和未圆的在线算法来计算SCORE2风险.
- 结果包括心血管疾病事件,治疗资格和歧视 (C-统计).
主要成果:
- 风险图预测,在低风险和高风险地区,10年内心血管疾病风险高于在线计算器.
- 基于图表的评估导致更高的治疗资格 (6.3%与4.0%低风险;51%与43%高风险).
- 在线计算器证明了优越的歧视 (C统计差异+0.010和+0.008).
结论:
- 与未圆的在线计算器相比,SCORE2风险图表高估了风险,并扩大了治疗资格.
- 在线计算器提供了更好的歧视,可能导致更准确的预防性治疗决策.
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