RT Journal Article
SR Electronic
T1 Prediction models for the risk of cardiovascular disease in patients with type 2 diabetes: a systematic review
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 360
OP 369
DO 10.1136/heartjnl-2011-300734
VO 98
IS 5
A1 S van Dieren
A1 J W J Beulens
A1 A P Kengne
A1 L M Peelen
A1 G E H M Rutten
A1 M Woodward
A1 Y T van der Schouw
A1 K G M Moons
YR 2012
UL http://heart.bmj.com/content/98/5/360.abstract
AB Context A recent overview of all CVD models applicable to diabetes patients is not available.Objective To review the primary prevention studies that focused on the development, validation and impact assessment of a cardiovascular risk model, scores or rules that can be applied to patients with type 2 diabetes.Design Systematic review.Data sources Medline was searched from 1966 to 1 April 2011.Study selection A study was eligible when it described the development, validation or impact assessment of a model that was constructed to predict the occurrence of cardiovascular disease in people with type 2 diabetes, or when the model was designed for use in the general population but included diabetes as a predictor.Data extraction A standardized form was sued to extract all data of the CVD models.Results 45 prediction models were identified, of which 12 were specifically developed for patients with type 2 diabetes. Only 31% of the risk scores has been externally validated in a diabetes population, with an area under the curve ranging from 0.61 to 0.86 and 0.59 to 0.80 for models developed in a diabetes population and in the general population, respectively. Only one risk score has been studied for its effect on patient management and outcomes. 10% of the risk scores are advocated in national diabetes guidelines.Conclusion Many cardiovascular risk scores are available that can be applied to patients with type 2 diabetes. A minority of these risk scores has been validated and tested for its predictive accuracy, with only a few showing a discriminative value of ≥0.80. The impact of applying these risk scores in clinical practice is almost completely unknown, but their use is recommended in various national guidelines.