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Ukpds risk engine11/1/2022 ![]() In a cross-sectional study, Rakhit et al. Others compared the predictability using CVD surrogate mea sure similar to our study. Similar to our results, the few prospective studies comparing risk scores for diabetes patients have reported no significant difference among risk scores. The AUCs of the FRS and UKPDS scores for known diabetes patients were 0.60 and 0.61 and there was no significant difference. They observed the subjects for 10.5 years and compared the predictability of the FRS with that of UKPDS risk engine. 28) conducted a population-based cohort study of 9,000 people who presented to general practices for health exams in the United Kingdom. 27) compared the predictability of the FRS and SCORE with the UKPDS in 5,102 newly diagnosed type 2 patients and reported that the AUCs of the FRS and SCORE were similar (0.76 and 0.77, respectively). They compared the predictability of the FRS with that of the UKPDS risk engine and reported that the AUCs of the FRS and UKPDS were 0.657 and 0.670, respectively. 26) investigated a cohort composed of 428 newly diagnosed type 2 diabetes patients without clinically evident CVD in the United Kingdom for 4.2 years. Some researchers studied the predictability based on the observation of CVD events. The UKPDS includes the duration of diabetes and glycated hemoglobin (HbA 1c) level as variables, thus allowing it address the risk of CVD specifically in diabetes patients.Īdditional studies have compared the predictability among risk scores. 15) In 2001, the United Kingdom Prospective Diabetes Study (UKPDS) risk engine was published based on data from 5,102 newly diagnosed type 2 patients who were followed-up for an average of 10.4 years. 12- 14) To correct this overestimation, the Systematic Coronary Risk Evaluation (SCORE) project was initiated to develop an appropriate risk estimation method for the general European population. 11) On the other hand, some European studies have reported that the FRS overestimates CVD risk in the general European population. Because very few diabetes patients were included in this previous study, some uncertainty remains according the accuracy of the FRS to predict CVD risk in diabetes patients. The Framingham Risk Score (FRS) was developed to predict the incident risk of CVD according to age, low-density lipoprotein (LDL) levels, high-density lipoprotein (HDL) levels, smoking, and hypertension. 10) estimated the risk of CVD using data from the Framingham heart study. The risk engine accurately predicts macro- and microvascular complications and would provide helpful information in risk classification and health economic simulations.Wilson et al. By combining macro- and microvascular risks, the classification of low- and high-risk patients was improved by a net reclassification improvement of 5.7% (P = 0.02). C statistics in our Japanese patients were high for CHD, noncardiovascular mortality, and overt nephropathy (0.725, 0.696, and 0.767) but moderate for stroke and progression of retinopathy (0.636 and 0.614). In contrast, the UK Prospective Diabetes Study (UKPDS) risk engine overestimated CHD risk (O/P ratios: 0.30 for CHD and 0.72 for stroke). The observed-to-predicted (O/P) ratios for each event were between 0.93 and 1.08, and Hosmer-Lemeshow tests showed no significant deviations between observed and predicted events. Sex, age, HbA1c, years after diagnosis, BMI, systolic blood pressure, non-HDL cholesterol, albumin-to-creatinine ratio, atrial fibrillation, current smoker, and leisure-time physical activity were risk factors for macro- and microvascular complications and were incorporated into the risk engine. The predictive accuracy of the calculated 5-year risks was cross-validated. We fit a multistate Cox regression model to derive an algorithm for prediction. End points were coronary heart disease (CHD), stroke, noncardiovascular mortality, overt nephropathy defined by persistent proteinuria, and progression of retinopathy. We analyzed pooled data from two clinical trials on 1,748 Japanese type 2 diabetic patients without diabetes complications other than mild diabetic retinopathy with a median follow-up of 7.2 years. To develop and validate a risk engine that calculates the risks of macro- and microvascular complications in type 2 diabetes. ![]()
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