Clinical prediction models in epidemiological studies: lessons from the application of QRISK3 to UK Biobank Data

Statistical models for clinical risk prediction are often derived using data from primary care databases; however, they are frequently used outside of clinical settings. The use of prediction models in epidemiological studies without external validation may lead to inaccurate results. We use the exa...

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Príomhchruthaitheoirí: Parsons, RE, Colopy, GW, Clifton, DA, Clifton, L
Formáid: Journal article
Teanga:English
Foilsithe / Cruthaithe: School of Statistics, Renmin University of China 2022
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author Parsons, RE
Colopy, GW
Clifton, DA
Clifton, L
author_facet Parsons, RE
Colopy, GW
Clifton, DA
Clifton, L
author_sort Parsons, RE
collection OXFORD
description Statistical models for clinical risk prediction are often derived using data from primary care databases; however, they are frequently used outside of clinical settings. The use of prediction models in epidemiological studies without external validation may lead to inaccurate results. We use the example of applying the QRISK3 model to data from the United Kingdom (UK) Biobank study to illustrate the challenges and provide suggestions for future authors. The QRISK3 model is recommended by the National Institute for Health and Care Excellence (NICE) as a tool to aid cardiovascular risk prediction in English and Welsh primary care patients aged between 40 and 74. QRISK3 has not been externally validated for use in studies where data is collected for more general scientific purposes, including the UK Biobank study. This lack of external validation is important as the QRISK3 scores of participants in UK Biobank have been used and reported in several publications. This paper outlines: (i) how various publications have used QRISK3 on UK Biobank data and (ii) the ways that the lack of external validation may affect the conclusions from these publications. We then propose potential solutions for addressing these challenges; for example, model recalibration and considering alternative models, for the application of traditional statistical models such as QRISK3, in cohorts without external validation.
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spelling oxford-uuid:8f3c4927-1fed-4819-bcc4-4bc138ed61972023-10-02T14:46:53ZClinical prediction models in epidemiological studies: lessons from the application of QRISK3 to UK Biobank DataJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8f3c4927-1fed-4819-bcc4-4bc138ed6197EnglishSymplectic ElementsSchool of Statistics, Renmin University of China2022Parsons, REColopy, GWClifton, DAClifton, LStatistical models for clinical risk prediction are often derived using data from primary care databases; however, they are frequently used outside of clinical settings. The use of prediction models in epidemiological studies without external validation may lead to inaccurate results. We use the example of applying the QRISK3 model to data from the United Kingdom (UK) Biobank study to illustrate the challenges and provide suggestions for future authors. The QRISK3 model is recommended by the National Institute for Health and Care Excellence (NICE) as a tool to aid cardiovascular risk prediction in English and Welsh primary care patients aged between 40 and 74. QRISK3 has not been externally validated for use in studies where data is collected for more general scientific purposes, including the UK Biobank study. This lack of external validation is important as the QRISK3 scores of participants in UK Biobank have been used and reported in several publications. This paper outlines: (i) how various publications have used QRISK3 on UK Biobank data and (ii) the ways that the lack of external validation may affect the conclusions from these publications. We then propose potential solutions for addressing these challenges; for example, model recalibration and considering alternative models, for the application of traditional statistical models such as QRISK3, in cohorts without external validation.
spellingShingle Parsons, RE
Colopy, GW
Clifton, DA
Clifton, L
Clinical prediction models in epidemiological studies: lessons from the application of QRISK3 to UK Biobank Data
title Clinical prediction models in epidemiological studies: lessons from the application of QRISK3 to UK Biobank Data
title_full Clinical prediction models in epidemiological studies: lessons from the application of QRISK3 to UK Biobank Data
title_fullStr Clinical prediction models in epidemiological studies: lessons from the application of QRISK3 to UK Biobank Data
title_full_unstemmed Clinical prediction models in epidemiological studies: lessons from the application of QRISK3 to UK Biobank Data
title_short Clinical prediction models in epidemiological studies: lessons from the application of QRISK3 to UK Biobank Data
title_sort clinical prediction models in epidemiological studies lessons from the application of qrisk3 to uk biobank data
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