Predictive modeling using a nationally representative database to identify patients at risk of developing microalbuminuria.

PURPOSE

Predictive models allow clinicians to identify higher- and lower-risk patients and make targeted treatment decisions. Microalbuminuria (MA) is a condition whose presence is understood to be an early marker for cardiovascular disease. The aims of this study were to develop a patient data-driven predictive model and a risk-score assessment to improve the identification of MA.

METHODS

The 2007-2008 National Health and Nutrition Examination Survey (NHANES) was utilized to create a predictive model. The dataset was split into thirds; one-third was used to develop the model, while the other two-thirds were utilized for internal validation. The 2012-2013 NHANES was used as an external validation database. Multivariate logistic regression was performed to create the model. Performance was evaluated using three criteria: (1) receiver operating characteristic curves; (2) pseudo-R (2) values; and (3) goodness of fit (Hosmer-Lemeshow). The model was then used to develop a risk-score chart.

RESULTS

A model was developed using variables for which there was a significant relationship. Variables included were systolic blood pressure, fasting glucose, C-reactive protein, blood urea nitrogen, and alcohol consumption. The model performed well, and no significant differences were observed when utilized in the validation datasets. A risk score was developed, and the probability of developing MA for each score was calculated.

CONCLUSION

The predictive model provides new evidence about variables related with MA and may be used by clinicians to identify at-risk patients and to tailor treatment. The risk score developed may allow clinicians to measure a patient's MA risk.