Prevention & lipidsDiagnostic or prognostic study
Predictive performance of established cardiovascular risk scores in the prediabetic population: external validation using the UK Biobank data set
- External validation study (prognostic models)
- UK Biobank cohort
Authors' conclusion
Neither risk stratification schemes for the general population nor those specific for Type 2 diabetes performed well in the prediabetic population.
Study context
- Population
- Adults aged 40–69 years with prediabetes (HbA1c ≥ 5.7 and <6.5%) without baseline cardiovascular disease (CVD) or known diabetes, UK Biobank4,303 incident CVD events
- Participants
- 56,831 adults
- Comparison
- 11 CVD risk scores: 5 general population-based vs 6 diabetes-specific
- Outcome
- Discrimination (Harrell's C-statistic) and calibration for 10- or 5-year CVD risk
Performance
As reported in the abstract
Discrimination (C-statistic) · median follow-up 8.9 years
General population-based scores
0.647-0.675
C-statistic
Diabetes-specific scores
0.647-0.680
C-statistic
PREDICT-1° Diabetes equation
0.680
C-statistic · 95% CI 0.672–0.689
- All 11 scores had modest discrimination
- 0.647 to 0.680
Further findings
Calibration
- Overall poor calibration; PREDICT-1° Diabetes equation calibrated well after recalibration
Decision curve analysis
- Moderate clinical usefulness of each model, worse at high threshold probabilities
Original publication
Predictive performance of established cardiovascular risk scores in the prediabetic population: external validation using the UK Biobank data set. Eur J Prev Cardiol. Published 10 April 2023. doi:10.1093/eurjpc/zwad106
Summarised from the published abstract; every number is checked against it