Eva Pagano1, Stefan R A Konings2, Daniela Di Cuonzo1, Rosalba Rosato3, Graziella Bruno4, Amber A van der Heijden5,6, Joline Beulens6, Roderick Slieker6,7, Jose Leal8, Talitha L Feenstra9,10. 1. Unit of Clinical Epidemiology, "Città della Salute e della Scienza" Hospital and CPO Piemonte, Turin, Italy. 2. Department of Psychiatry, University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands. 3. Department of Psychology, University of Turin, Turin, Italy. 4. Laboratory of Diabetic Nephropathy, Department of Medical Sciences, University of Turin, Turin, Italy. 5. Department of General Practice, Amsterdam Public Health Institute, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands. 6. Department of Epidemiology and Biostatistics, Amsterdam Public Health Institute, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands. 7. Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands. 8. Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 9. University of Groningen, Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, Groningen, The Netherlands. 10. RIVM, Bilthoven, The Netherlands.
Abstract
AIM: To externally validate the UK Prospective Diabetes Study Outcomes Model version 2 (UKPDS-OM2) by comparing the predicted and observed outcomes in two European population-based cohorts of people with type 2 diabetes. MATERIALS AND METHODS: We used data from the Casale Monferrato Survey (CMS; n = 1931) and a subgroup of the Hoorn Diabetes Care System (DCS) cohort (n = 5188). The following outcomes were analysed: all-cause mortality, myocardial infarction (MI), ischaemic heart disease (IHD), stroke, and congestive heart failure (CHF). Model performance was assessed by comparing predictions with observed cumulative incidences in each cohort during follow-up. RESULTS: All-cause mortality was overestimated by the UKPDS-OM2 in both the cohorts, with a bias of 0.05 in the CMS and 0.12 in the DCS at 10 years of follow-up. For MI, predictions were consistently higher than observed incidence over the entire follow-up in both cohorts (10 years bias 0.07 for CMS and 0.10 for DCS). The model performed well for stroke and IHD outcomes in both cohorts. CHF incidence was predicted well for the DCS (5 years bias -0.001), but underestimated for the CMS cohort. CONCLUSIONS: The UKPDS-OM2 consistently overpredicted the risk of mortality and MI in both cohorts during follow-up. Period effects may partially explain the differences. Results indicate that transferability is not satisfactory for all outcomes, and new or adjusted risk equations may be needed before applying the model to the Italian or Dutch settings.
AIM: To externally validate the UK Prospective Diabetes Study Outcomes Model version 2 (UKPDS-OM2) by comparing the predicted and observed outcomes in two European population-based cohorts of people with type 2 diabetes. MATERIALS AND METHODS: We used data from the Casale Monferrato Survey (CMS; n = 1931) and a subgroup of the Hoorn Diabetes Care System (DCS) cohort (n = 5188). The following outcomes were analysed: all-cause mortality, myocardial infarction (MI), ischaemic heart disease (IHD), stroke, and congestive heart failure (CHF). Model performance was assessed by comparing predictions with observed cumulative incidences in each cohort during follow-up. RESULTS: All-cause mortality was overestimated by the UKPDS-OM2 in both the cohorts, with a bias of 0.05 in the CMS and 0.12 in the DCS at 10 years of follow-up. For MI, predictions were consistently higher than observed incidence over the entire follow-up in both cohorts (10 years bias 0.07 for CMS and 0.10 for DCS). The model performed well for stroke and IHD outcomes in both cohorts. CHF incidence was predicted well for the DCS (5 years bias -0.001), but underestimated for the CMS cohort. CONCLUSIONS: The UKPDS-OM2 consistently overpredicted the risk of mortality and MI in both cohorts during follow-up. Period effects may partially explain the differences. Results indicate that transferability is not satisfactory for all outcomes, and new or adjusted risk equations may be needed before applying the model to the Italian or Dutch settings.
Authors: Frauke Becker; Helen A Dakin; Shelby D Reed; Yanhong Li; José Leal; Stephanie M Gustavson; Eric Wittbrodt; Adrian F Hernandez; Alastair M Gray; Rury R Holman Journal: Diabetes Res Clin Pract Date: 2021-11-20 Impact factor: 5.602
Authors: Mi Jun Keng; Jose Leal; Marion Mafham; Louise Bowman; Jane Armitage; Borislava Mihaylova Journal: Value Health Date: 2021-10-27 Impact factor: 5.101