Journal article
WHO cardiovascular disease risk prediction model performance in 10 regions, China
- Alternative title:
- Validation of the World Health Organization non-laboratory-based cardiovascular disease risk prediction models in ten diverse regions of China
- Abstract:
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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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
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(Preview, Accepted manuscript, pdf, 606.6KB, Terms of use)
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- Publisher copy:
- 10.2471/BLT.22.288645
Authors
- Publisher:
- World Health Organization
- Journal:
- Bulletin of the World Health Organization More from this journal
- Volume:
- 101
- Issue:
- 4
- Pages:
- 238–247
- Publication date:
- 2023-02-01
- Acceptance date:
- 2022-12-07
- DOI:
- EISSN:
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1564-0604
- ISSN:
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0042-9686
- Language:
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English
- Keywords:
- Pubs id:
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1313485
- Local pid:
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pubs:1313485
- Deposit date:
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2022-12-09
- ARK identifier:
Terms of use
- Copyright holder:
- Yang et al.
- Copyright date:
- 2023
- Rights statement:
- © 2023 The Author(s).
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from PubMed at: https://dx.doi.org/10.2471/BLT.22.288645
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