Do population-level risk prediction models that use routinely collected health data reliably predict individual risks?

Scientific Reports
Yan LiTjeerd Pieter van Staa

Abstract

The objective of this study was to assess the reliability of individual risk predictions based on routinely collected data considering the heterogeneity between clinical sites in data and populations. Cardiovascular disease (CVD) risk prediction with QRISK3 was used as exemplar. The study included 3.6 million patients in 392 sites from the Clinical Practice Research Datalink. Cox models with QRISK3 predictors and a frailty (random effect) term for each site were used to incorporate unmeasured site variability. There was considerable variation in data recording between general practices (missingness of body mass index ranged from 18.7% to 60.1%). Incidence rates varied considerably between practices (from 0.4 to 1.3 CVD events per 100 patient-years). Individual CVD risk predictions with the random effect model were inconsistent with the QRISK3 predictions. For patients with QRISK3 predicted risk of 10%, the 95% range of predicted risks were between 7.2% and 13.7% with the random effects model. Random variability only explained a small part of this. The random effects model was equivalent to QRISK3 for discrimination and calibration. Risk prediction models based on routinely collected health data perform well for populations but ...Continue Reading

References

Jan 1, 1995·Lifetime Data Analysis·P Hougaard
Sep 4, 1999·Statistics in Medicine·E GrafM Schumacher
Dec 2, 2005·Statistics in Medicine·Laura AntoliniElia Biganzoli
Nov 14, 2006·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Andrew J Vickers, Elena B Elkin
Dec 7, 2006·Journal of the National Cancer Institute·Joann G Elmore, Suzanne W Fletcher
Jun 25, 2008·BMJ : British Medical Journal·Julia Hippisley-CoxPeter Brindle
Jul 14, 2010·Progress in Cardiovascular Diseases·Asaf Bitton, Thomas A Gaziano
Feb 18, 2011·BMJ : British Medical Journal·John M HackingIain E Buchan
Mar 30, 2011·Therapeutics and Clinical Risk Management·Daniele FranchiGiorgio Iervasi
Jun 19, 2012·Journal of Epidemiology and Community Health·Martin O'Flaherty, Simon Capewell
May 7, 2013·Cancer Epidemiology·Aaron P Thrift, David C Whiteman
Aug 6, 2014·Statistical Methods in Medical Research·Carlos SáezJuan M García-Gómez
Mar 19, 2015·Nursing Standard·Margaret Arthur
Jun 8, 2015·International Journal of Epidemiology·Emily HerrettLiam Smeeth
Dec 4, 2015·Korean journal of anesthesiology·Tae Kyun Kim
May 18, 2016·BMJ : British Medical Journal·Johanna A A G DamenKarel G M Moons
Mar 27, 2018·Statistics in Medicine·L WynantsB Van Calster

❮ Previous
Next ❯

Software Mentioned

QRISK3
QResearch
SAS
coxme
QRISK2
QRISK
R

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.