National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT.
The George Institute for Global Health, University of New South Wales, Sydney, NSW.
Med J Aust. 2023 Aug 21;219(4):173-186. doi: 10.5694/mja2.52052. Epub 2023 Jul 26.
This article reviews the risk equations recommended for use in international cardiovascular disease (CVD) primary prevention guidelines and assesses their suitability for use in Australia against a set of a priori defined selection criteria. The review and assessment were commissioned by the National Heart Foundation of Australia on behalf of the Australian Chronic Disease Prevention Alliance to inform recommendations on CVD risk estimation as part of the 2023 update of the Australian CVD risk assessment and management guidelines. Selected international risk equations were assessed against eight selection criteria: development using contemporary data; inclusion of established cardiovascular risk factors; inclusion of ethnicity and deprivation measures; prediction of a broad selection of fatal and non-fatal CVD outcomes; population representativeness; model performance; external validation in an Australian dataset; and the ability to be recalibrated or modified. Of the ten risk prediction equations reviewed, the New Zealand PREDICT equation met seven of the eight selection criteria, and met additional usability criteria aimed at assessing the ability to apply the risk equation in practice in Australia.
本文回顾了国际心血管疾病(CVD)一级预防指南中推荐使用的风险方程,并根据一组事先确定的选择标准评估其在澳大利亚的适用性。该审查和评估是由澳大利亚国家心脏基金会代表澳大利亚慢性病预防联盟委托进行的,旨在为 CVD 风险评估提供建议,作为 2023 年澳大利亚 CVD 风险评估和管理指南更新的一部分。选定的国际风险方程根据以下八项选择标准进行评估:使用当代数据进行开发;包含已确立的心血管危险因素;包含种族和贫困措施;预测广泛的致命和非致命 CVD 结局;代表性人群;模型性能;在澳大利亚数据集的外部验证;以及重新校准或修改的能力。在审查的十个风险预测方程中,新西兰 PREDICT 方程符合八项选择标准中的七项,并且符合额外的可用性标准,旨在评估在澳大利亚实际应用风险方程的能力。