Impact Factor:13.831
DOI number:10.2471/BLT.22.288645
Journal:Bulletin of the World Health Organization
Key Words:Cardiovascular disease; Risk prediction model
Abstract:Objective: To validate the World Health Organization (WHO) non-laboratory-based cardiovascular disease risk prediction model in regions of China. Methods: We performed an external validation of the WHO model for East Asia using the data set of China Kadoorie Biobank, an ongoing cohort study with 512 725 participants recruited from 10 regions of China from 2004-2008. We also recalculated the recalibration parameters for the WHO model in each region and evaluated the predictive performance of the model before and after recalibration. We assessed discrimination performance by Harrell's C index. Findings: We included 412 225 participants aged 40-79 years. During a median follow-up of 11 years, 58 035 and 41 262 incident cardiovascular disease cases were recorded in women and men, respectively. Harrell's C of the WHO model was 0.682 in women and 0.700 in men but varied among regions. The WHO model underestimated the 10-year cardiovascular disease risk in most regions. After recalibration in each region, discrimination and calibration were both improved in the overall population. Harrell's C increased from 0.674 to 0.749 in women and from 0.698 to 0.753 in men. The ratios of predicted to observed cases before and after recalibration were 0.189 and 1.027 in women and 0.543 and 1.089 in men. Conclusion: The WHO model for East Asia yielded moderate discrimination for cardiovascular disease in the Chinese population and had limited prediction for cardiovascular disease risk in different regions in China. Recalibration for diverse regions greatly improved discrimination and calibration in the overall population.
Co-author:Yinqi Ding, Canqing Yu, Yu Guo, Yuanjie Pang, Dianjianyi Sun, Pei Pei, Ling Yang, Yiping Chen, Huaidong Du, Dan Schmidt, Rebecca Stevens, Derrick Bennett, Robert Clarke, Junshi Chen, Zhengming Chen, Liming Li, China Kadoorie Biobank Collaborative Group
First Author:Songchun Yang
Indexed by:Journal paper
Correspondence Author:Jun Lv
Document Code:PMID: 37008262
Discipline:Medicine
First-Level Discipline:Public Health and Preventive Medicine
Document Type:J
Volume:101
Issue:4
Page Number:238-247
ISSN No.:0042-9686
Translation or Not:no
Included Journals:SCI
Links to published journals:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042093/pdf/BLT.22.288645.pdf