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QDSCORE(®) 预测 10 年发生 2 型糖尿病风险的外部验证。

External validation of QDSCORE(®) for predicting the 10-year risk of developing Type 2 diabetes.

机构信息

Centre for Statistics in Medicine, University of Oxford, Oxford UK.

出版信息

Diabet Med. 2011 May;28(5):599-607. doi: 10.1111/j.1464-5491.2011.03237.x.

Abstract

BACKGROUND

A small number of risk scores for the risk of developing diabetes have been produced but none has yet been widely used in clinical practice in the UK. The aim of this study is to independently evaluate the performance of QDSCORE(®) for predicting the 10-year risk of developing diagnosed Type 2 diabetes in a large independent UK cohort of patients from general practice.

METHODS

A prospective cohort study of 2.4 million patients (13.6 million person years) aged between 25 and 79 years from 364 practices from the UK contributing to The Health Improvement Network (THIN) database between 1 January 1993 and 20 June 2008.

RESULTS

QDSCORE(®) showed good performance data when evaluated on a large external data set. The score is well calibrated with reasonable agreement between observed and predicted outcomes. There is a slight underestimation of risk in both men and women aged 60 years and above, although the magnitude of underestimation is small. The ability of the score to differentiate between those who develop diabetes and those who do not is good, with values for the area under the receiver operating characteristic curve exceeding 0.8 for both men and women. Performance data in this external validation are consistent with those reported in the development and internal validation of the risk score.

CONCLUSIONS

QDSCORE(®) has shown to be a useful tool to predict the 10-year risk of developing Type 2 diabetes in the UK.

摘要

背景

已经开发出了少数几种用于预测糖尿病发病风险的风险评分,但在英国,这些评分都尚未广泛应用于临床实践。本研究旨在独立评估 QDSCORE(®)在预测英国大型普通实践患者队列中 10 年内确诊 2 型糖尿病发病风险方面的性能。

方法

这是一项前瞻性队列研究,纳入了来自英国 364 个实践的年龄在 25 至 79 岁之间的 240 万患者(1360 万人年),这些患者的数据来自于 1993 年 1 月 1 日至 2008 年 6 月 20 日期间的英国健康改进网络(THIN)数据库。

结果

在大型外部数据集上评估时,QDSCORE(®)表现出良好的性能数据。该评分具有良好的校准度,观察到的和预测的结果之间具有合理的一致性。尽管低估的幅度很小,但 60 岁及以上男性和女性的风险存在轻微低估。该评分区分发生糖尿病和未发生糖尿病的患者的能力良好,男性和女性的受试者工作特征曲线下面积均超过 0.8。该风险评分在外部验证中的性能数据与在开发和内部验证中报告的数据一致。

结论

QDSCORE(®)已被证明是一种有用的工具,可用于预测英国人群中 2 型糖尿病的 10 年发病风险。

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