Development and Validation of the CANHEART Population-Based Laboratory Prediction Models for Atherosclerotic Cardiovascular Disease
Authors' conclusion
The CANHEART Lab Models predict ASCVD with similar accuracy to more complex models, such as the PCEs.
Study context
- Population
- Adults aged 40 to 75 years without CVD, Ontario, Canada; external validation in primary care patients31,697 external validation
- Comparison
- CANHEART Lab Models vs pooled cohort equations (PCEs)
- Outcome
- Atherosclerotic cardiovascular disease (ASCVD) (MI, stroke, death from ischemic heart or cerebrovascular disease)
- Follow-up
- Within 5 years
Methodological detailspopulation-based cohort, sex-specific models, internal and external validation, Medication use was not available at the population level
- Population-based cohort
- Sex-specific models
- Internal and external validation
- Medication use was not available at the population level
Performance
As reported in the abstract
Internal validation: calibration and discrimination (c-statistic) · 5 years
Relative difference between mean predicted and observed risk, both sexes
less than 1%
C-statistic, women
0.77
C-statistic, men
0.71
Further findings
| Outcome | Change in c-statistic (95% CI) |
|---|---|
| External validation: c-statistic, Lab Models vs PCEs · 5 yearsCANHEART Lab Models vs PCEs · women; not statistically significant | −0.01 (−0.03 to 0.01) |
| External validation: c-statistic, Lab Models vs PCEs · 5 yearsCANHEART Lab Models vs PCEs · men; not statistically significant | −0.01 (−0.04 to 0.02) |
- External validation: c-statistic, Lab Models vs PCEs — c-statistic of Lab Models, both sexes
- 0.72
External validation (primary care, n = 31 697): calibration · 5 years
- Relative difference between mean predicted and observed risk, both sexes
- less than 14%
- Absolute difference between mean predicted and observed risk, both sexes
- less than 0.3 percentage points
Original publication
Development and Validation of the CANHEART Population-Based Laboratory Prediction Models for Atherosclerotic Cardiovascular Disease. Ann Intern Med. Published 12 December 2023. doi:10.
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