Developing Non-Laboratory Cardiovascular Risk Assessment Charts and Validating Laboratory and Non-Laboratory-Based Models

Background: Developing simplified risk assessment model based on non-laboratory risk factors that could determine cardiovascular risk as accurately as laboratory-based one can be valuable, particularly in developing countries where there are limited resources. Objective: To develop a simplified non-...

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Main Authors: Razieh Hassannejad, Marjan Mansourian, Hamidreza Marateb, Mohammad Reza Mohebian, Thomas Andrew Gaziano, Rodney T Jackson, Emanuele Di Angelantonio, Nizal Sarrafzadegan
Format: Article
Language:English
Published: Ubiquity Press 2021-09-01
Series:Global Heart
Subjects:
Online Access:https://globalheartjournal.com/articles/890
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author Razieh Hassannejad
Marjan Mansourian
Hamidreza Marateb
Mohammad Reza Mohebian
Thomas Andrew Gaziano
Rodney T Jackson
Emanuele Di Angelantonio
Nizal Sarrafzadegan
author_facet Razieh Hassannejad
Marjan Mansourian
Hamidreza Marateb
Mohammad Reza Mohebian
Thomas Andrew Gaziano
Rodney T Jackson
Emanuele Di Angelantonio
Nizal Sarrafzadegan
author_sort Razieh Hassannejad
collection DOAJ
description Background: Developing simplified risk assessment model based on non-laboratory risk factors that could determine cardiovascular risk as accurately as laboratory-based one can be valuable, particularly in developing countries where there are limited resources. Objective: To develop a simplified non-laboratory cardiovascular disease risk assessment chart based on previously reported laboratory-based chart and evaluate internal and external validation, and recalibration of both risk models to assess the performance of risk scoring tools in other population. Methods: A 10-year non-laboratory-based risk prediction chart was developed for fatal and non-fatal CVD using Cox Proportional Hazard regression. Data from the Isfahan Cohort Study (ICS), a population-based study among 6504 adults aged ≥ 35 years, followed-up for at least ten years was used for the non-laboratory-based model derivation. Participants were followed up until the occurrence of CVD events. Tehran Lipid and Glucose Study (TLGS) data was used to evaluate the external validity of both non-laboratory and laboratory risk assessment models in other populations rather than one used in the model derivation. Results: The discrimination and calibration analysis of the non-laboratory model showed the following values of Harrell’s C: 0.73 (95% CI 0.71–0.74), and Nam-D’Agostino χ2:11.01 (p = 0.27), respectively. The non-laboratory model was in agreement and classified high risk and low risk patients as accurately as the laboratory one. Both non-laboratory and laboratory risk prediction models showed good discrimination in the external validation, with Harrell’s C of 0.77 (95% CI 0.75–0.78) and 0.78 (95% CI 0.76–0.79), respectively. Conclusions: Our simplified risk assessment model based on non-laboratory risk factors could determine cardiovascular risk as accurately as laboratory-based one. This approach can provide simple risk assessment tool where laboratory testing is unavailable, inconvenient, and costly.
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spelling doaj.art-8bd14fab012f4690a43490967ace814a2022-12-21T21:23:48ZengUbiquity PressGlobal Heart2211-81792021-09-0116110.5334/gh.890873Developing Non-Laboratory Cardiovascular Risk Assessment Charts and Validating Laboratory and Non-Laboratory-Based ModelsRazieh Hassannejad0Marjan Mansourian1Hamidreza Marateb2Mohammad Reza Mohebian3Thomas Andrew Gaziano4Rodney T Jackson5Emanuele Di Angelantonio6Nizal Sarrafzadegan7Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, IsfahanDepartment of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR; Department of Automatic Control, Biomedical Engineering Research Center, Universitat Politècnica de Catalunya, BarcelonaTech (UPC), BarcelonaBiomedical Engineering Department, Engineering faculty, University of Isfahan, IsfahanDepartment of Electrical and Computer Engineering, University of Saskatchewan, Saskatoon, SK, S7N 5A9Brigham and Women's HospitalEpidemiology and Biostatistics Department, Population Health, Faculty of Medical and Health Sciences, University of Auckland, AucklandCardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, CambridgeIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British ColumbiaBackground: Developing simplified risk assessment model based on non-laboratory risk factors that could determine cardiovascular risk as accurately as laboratory-based one can be valuable, particularly in developing countries where there are limited resources. Objective: To develop a simplified non-laboratory cardiovascular disease risk assessment chart based on previously reported laboratory-based chart and evaluate internal and external validation, and recalibration of both risk models to assess the performance of risk scoring tools in other population. Methods: A 10-year non-laboratory-based risk prediction chart was developed for fatal and non-fatal CVD using Cox Proportional Hazard regression. Data from the Isfahan Cohort Study (ICS), a population-based study among 6504 adults aged ≥ 35 years, followed-up for at least ten years was used for the non-laboratory-based model derivation. Participants were followed up until the occurrence of CVD events. Tehran Lipid and Glucose Study (TLGS) data was used to evaluate the external validity of both non-laboratory and laboratory risk assessment models in other populations rather than one used in the model derivation. Results: The discrimination and calibration analysis of the non-laboratory model showed the following values of Harrell’s C: 0.73 (95% CI 0.71–0.74), and Nam-D’Agostino χ2:11.01 (p = 0.27), respectively. The non-laboratory model was in agreement and classified high risk and low risk patients as accurately as the laboratory one. Both non-laboratory and laboratory risk prediction models showed good discrimination in the external validation, with Harrell’s C of 0.77 (95% CI 0.75–0.78) and 0.78 (95% CI 0.76–0.79), respectively. Conclusions: Our simplified risk assessment model based on non-laboratory risk factors could determine cardiovascular risk as accurately as laboratory-based one. This approach can provide simple risk assessment tool where laboratory testing is unavailable, inconvenient, and costly.https://globalheartjournal.com/articles/890cardiovascular diseaserisk assessmentlaboratory-based modelnon-laboratory-based modelisfahan cohort study
spellingShingle Razieh Hassannejad
Marjan Mansourian
Hamidreza Marateb
Mohammad Reza Mohebian
Thomas Andrew Gaziano
Rodney T Jackson
Emanuele Di Angelantonio
Nizal Sarrafzadegan
Developing Non-Laboratory Cardiovascular Risk Assessment Charts and Validating Laboratory and Non-Laboratory-Based Models
Global Heart
cardiovascular disease
risk assessment
laboratory-based model
non-laboratory-based model
isfahan cohort study
title Developing Non-Laboratory Cardiovascular Risk Assessment Charts and Validating Laboratory and Non-Laboratory-Based Models
title_full Developing Non-Laboratory Cardiovascular Risk Assessment Charts and Validating Laboratory and Non-Laboratory-Based Models
title_fullStr Developing Non-Laboratory Cardiovascular Risk Assessment Charts and Validating Laboratory and Non-Laboratory-Based Models
title_full_unstemmed Developing Non-Laboratory Cardiovascular Risk Assessment Charts and Validating Laboratory and Non-Laboratory-Based Models
title_short Developing Non-Laboratory Cardiovascular Risk Assessment Charts and Validating Laboratory and Non-Laboratory-Based Models
title_sort developing non laboratory cardiovascular risk assessment charts and validating laboratory and non laboratory based models
topic cardiovascular disease
risk assessment
laboratory-based model
non-laboratory-based model
isfahan cohort study
url https://globalheartjournal.com/articles/890
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AT hamidrezamarateb developingnonlaboratorycardiovascularriskassessmentchartsandvalidatinglaboratoryandnonlaboratorybasedmodels
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