Yanglu Zhao1,2, Nathan D Wong3,4. 1. Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA. juliayanglu@ucla.edu. 2. Heart Disease Prevention Program, University of California, Irvine, Irvine, CA, USA. juliayanglu@ucla.edu. 3. Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E Young Drive, Los Angeles, CA, 90095, USA. 4. Heart Disease Prevention Program, University of California, Irvine, Irvine, CA, USA.
Abstract
PURPOSE OF REVIEW: We briefly introduce the concept and use of cardiovascular disease (CVD) risk scores and review the methodology for CVD risk score development and validation in patients with diabetes. We also discuss CVD risk scores for diabetic patients that have been developed in different countries. RECENT FINDINGS: Patients with diabetes have a gradient of CVD risk that needs to be accurately assessed. Numerous CVD risk scores for diabetic patients have been created in various settings. The methods to develop risk scores are highly diverse and each choice has its own pros and cons. A well-constructed risk score for diabetic patients may be advocated by guidelines and adopted by healthcare providers to help determine preventive strategies. New risk factors are being investigated in order to improve the predictive accuracy of current risk scores. A suitable CVD risk score for the diabetes population should be accurate, low-cost, and beneficial to outcome. While the performance (accuracy) has all been internally validated, validation on external populations is still needed. Cost-effectiveness and clinical trials demonstrating improvement in outcomes are limited and should be the target of future research.
PURPOSE OF REVIEW: We briefly introduce the concept and use of cardiovascular disease (CVD) risk scores and review the methodology for CVD risk score development and validation in patients with diabetes. We also discuss CVD risk scores for diabeticpatients that have been developed in different countries. RECENT FINDINGS:Patients with diabetes have a gradient of CVD risk that needs to be accurately assessed. Numerous CVD risk scores for diabeticpatients have been created in various settings. The methods to develop risk scores are highly diverse and each choice has its own pros and cons. A well-constructed risk score for diabeticpatients may be advocated by guidelines and adopted by healthcare providers to help determine preventive strategies. New risk factors are being investigated in order to improve the predictive accuracy of current risk scores. A suitable CVD risk score for the diabetes population should be accurate, low-cost, and beneficial to outcome. While the performance (accuracy) has all been internally validated, validation on external populations is still needed. Cost-effectiveness and clinical trials demonstrating improvement in outcomes are limited and should be the target of future research.
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