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Prediction models for the risk of cardiovascular disease in patients with type 2 diabetes: a systematic review.
MedLine Citation:
PMID:  22184101     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ContextA recent overview of all CVD models applicable to diabetes patients is not available.ObjectiveTo review the primary prevention studies that focused on the development, validation and impact assessment of a cardiovascular risk model, scores or rules that can be applied to patients with type 2 diabetes.DesignSystematic review.Data sourcesMedline was searched from 1966 to 1 April 2011.Study selectionA study was eligible when it described the development, validation or impact assessment of a model that was constructed to predict the occurrence of cardiovascular disease in people with type 2 diabetes, or when the model was designed for use in the general population but included diabetes as a predictor.Data extractionA standardized form was sued to extract all data of the CVD models.Results45 prediction models were identified, of which 12 were specifically developed for patients with type 2 diabetes. Only 31% of the risk scores has been externally validated in a diabetes population, with an area under the curve ranging from 0.61 to 0.86 and 0.59 to 0.80 for models developed in a diabetes population and in the general population, respectively. Only one risk score has been studied for its effect on patient management and outcomes. 10% of the risk scores are advocated in national diabetes guidelines.ConclusionMany cardiovascular risk scores are available that can be applied to patients with type 2 diabetes. A minority of these risk scores has been validated and tested for its predictive accuracy, with only a few showing a discriminative value of ≥0.80. The impact of applying these risk scores in clinical practice is almost completely unknown, but their use is recommended in various national guidelines.
Authors:
S van Dieren; J W J Beulens; A P Kengne; L M Peelen; G E H M Rutten; M Woodward; Y T van der Schouw; K G M Moons
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-18
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  -     ISSN:  1468-201X     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University Medical Center Utrecht, Utrecht, The Netherlands.
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