Journal
AMERICAN JOURNAL OF EPIDEMIOLOGY
Volume 160, Issue 7, Pages 707-716Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwh258
Keywords
cohort studies; coronary disease; logistic models; proportional hazards models; risk assessment; risk factors; validation studies [publication type]
Categories
Ask authors/readers for more resources
Most existing coronary risk assessment methods are based on baseline data only. The authors compared the predictive ability of coronary multivariable risk scores based on updated versus baseline risk factors and investigated the optimal frequency of updating. Data from 16 biennial examinations of 4,962 subjects from the original Framingham Heart Study (1948-1978) were used. The predictive ability of three multivariable risk scores was evaluated through 10-fold cross-validation. The baseline-only multivariable risk score was computed using baseline values of coronary risk factors applied to a Cox model estimated from baseline data. The two other approaches relied on updated risk factors and included them in the models estimated from, respectively, baseline and updated data. All analyses were stratified by sex and age. For 30, 14, and 10 years of follow-up, the predictive ability of the baseline-only multivariable risk score was substantially poorer than that of the models using updated risk factors. Between the two latter models, the one estimated from updated data ensured better prediction than the one estimated from baseline data for 30 years of follow-up among younger subjects only. The results suggest that coronary risk assessment can be improved by utilizing updated risk factors and that the optimal frequency of updating may vary across subpopulations.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available