年轻成年人的预防方程:跨种族和民族群体的公平性,校准性和表现性
Abigail M Gauen1, Lucia C Petito1, Yiyi Zhang2
1Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA.
Journal of the American College of Cardiology
|February 4, 2026
概括
PREVENT方程显示了对年轻成年人心血管疾病风险的公平歧视,但在种族群体之间存在校准问题. 增加社会贫困指数并没有提高公平性或绩效.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 年轻成年人患心血管疾病 (CVD) 的风险正在上升.
- 美国心脏协会的PREVENT方程估计了心血管疾病,ASCVD和HF风险.
- 增强式方程将社会剥夺指数 (SDI) 纳入社会暴露.
研究的目的:
- 在年轻成年人 (20-39岁) 中评估基础和SDI增强的PREVENT方程的性能和算法公平性.
- 将公平性定义为跨种族和种族群体的相似表现.
- 对30-39岁的成年人进行初级分析,对20-29岁的成年人进行探索性分析.
主要方法:
- 包括161,202名凯泽永恒南加州20-39岁的会员,没有先前的CVD (2008-2019).
- 使用基准和SDI增强的PREVENT模型,比较10年预测与观察到的CVD,ASCVD和HF事件.
- 按种族/种族和年龄组估计的表现 (C统计,校准) 和公平性 (一致性不公平,公平校准).
主要成果:
- 基准PREVENT CVD模型显示了公平的歧视 (C-统计学0.68-0.72) 与低的一致性不一致性 (0.04).
- 与其他组 (0.96-1.07) 相比,非西班牙裔黑人参与者的平均校准显示预测不足 (0.54).
- 预测错误在种族/族群之间有所不同;SDI增强没有提高性能或公平性.
结论:
- PREVENT方程在一个多元化的年轻成年人群中展示了现实世界的表现.
- 模型的表现因年龄,种族和种族而异.
- 预防策略中PREVENT的临床应用需要考虑这些性能变化.
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