Wei-Syun Hu1,2, Cheng-Li Lin3. 1. School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. 2. Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan. 3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Abstract
BACKGROUND: We report on a retrospective population study aimed at identifying and validating the progression of adapted Diabetes Complications Severity Index (DCSI) for acute coronary syndrome (ACS), ischemic stroke, and mortality in Asian people with type 2 diabetes mellitus (DM). METHODS: Utilizing a Taiwanese national dataset, we included 84 450 type 2 diabetic individuals between 2000 and 2011. The area under the receiver operating characteristic curve (C statistics of logistic model) and the C statistics of the Cox model were used to evaluate whether the progression of diabetic complication status could be a predictor of ACS, ischemic stroke, and death. The optimum threshold for adverse outcomes risk stratification were obtained using Youden's J statistic as the cutoff that gives the highest threshold. RESULTS: Among the study patients, the C statistics of the logistic model of the progression of the score predictive of ACS, ischemic stroke, and death were 0.72 (95% confidence interval [CI]: 0.71-0.73), 0.84 (95% CI: 0.84-0.85), and 0.66 (95% CI: 0.65-0.67), respectively. The progression of adapted DCSI had moderate discrimination for ACS, ischemic stroke, and death (C statistics = 0.71, 0.72, and 0.75, respectively) based on Cox regression analysis (Harrell C). The optimum threshold of the progression of the score for ACS, ischemic stroke, and death in type 2 DM patients were 0.30, 0.36, and 0.39, respectively. CONCLUSIONS: The acceptable discriminative power of the progression of adapted DCSI for Asian people affected by type 2 DM was demonstrated in a large cohort in Taiwan.
BACKGROUND: We report on a retrospective population study aimed at identifying and validating the progression of adapted Diabetes Complications Severity Index (DCSI) for acute coronary syndrome (ACS), ischemic stroke, and mortality in Asian people with type 2 diabetes mellitus (DM). METHODS: Utilizing a Taiwanese national dataset, we included 84 450 type 2 diabetic individuals between 2000 and 2011. The area under the receiver operating characteristic curve (C statistics of logistic model) and the C statistics of the Cox model were used to evaluate whether the progression of diabetic complication status could be a predictor of ACS, ischemic stroke, and death. The optimum threshold for adverse outcomes risk stratification were obtained using Youden's J statistic as the cutoff that gives the highest threshold. RESULTS: Among the study patients, the C statistics of the logistic model of the progression of the score predictive of ACS, ischemic stroke, and death were 0.72 (95% confidence interval [CI]: 0.71-0.73), 0.84 (95% CI: 0.84-0.85), and 0.66 (95% CI: 0.65-0.67), respectively. The progression of adapted DCSI had moderate discrimination for ACS, ischemic stroke, and death (C statistics = 0.71, 0.72, and 0.75, respectively) based on Cox regression analysis (Harrell C). The optimum threshold of the progression of the score for ACS, ischemic stroke, and death in type 2 DMpatients were 0.30, 0.36, and 0.39, respectively. CONCLUSIONS: The acceptable discriminative power of the progression of adapted DCSI for Asian people affected by type 2 DM was demonstrated in a large cohort in Taiwan.
Authors: Gojka Roglic; Nigel Unwin; Peter H Bennett; Colin Mathers; Jaakko Tuomilehto; Satyajit Nag; Vincent Connolly; Hilary King Journal: Diabetes Care Date: 2005-09 Impact factor: 19.112
Authors: H Miettinen; S Lehto; V Salomaa; M Mähönen; M Niemelä; S M Haffner; K Pyörälä; J Tuomilehto Journal: Diabetes Care Date: 1998-01 Impact factor: 19.112
Authors: P M Clarke; A M Gray; A Briggs; A J Farmer; P Fenn; R J Stevens; D R Matthews; I M Stratton; R R Holman Journal: Diabetologia Date: 2004-10-27 Impact factor: 10.122
Authors: Xilin Yang; Wing Yee So; Peter C Y Tong; Ronald C W Ma; Alice P S Kong; Christopher W K Lam; Chung Shun Ho; Clive S Cockram; Gary T C Ko; Chun-Chung Chow; Vivian C W Wong; Juliana C N Chan Journal: Arch Intern Med Date: 2008-03-10
Authors: Brian J Wells; Anil Jain; Susana Arrigain; Changhong Yu; Wayne A Rosenkrans; Michael W Kattan Journal: Diabetes Care Date: 2008-09-22 Impact factor: 17.152
Authors: Hsien-Yen Chang; Jonathan P Weiner; Thomas M Richards; Sara N Bleich; Jodi B Segal Journal: Am J Manag Care Date: 2012-11 Impact factor: 2.229
Authors: X Shao; H Liu; F Hou; Y Bai; Z Cui; Y Lin; X Jiang; P Bai; Y Wang; Y Zhang; C Lu; H Liu; S Zhou; P Yu Journal: J Endocrinol Invest Date: 2022-08-16 Impact factor: 5.467