Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review
Background and objective This review compares non-laboratory-based and laboratory-based cardiovascular disease (CVD) risk prediction equations in populations targeted for primary prevention.Design Systematic review.Methods We searched five databases until 12 March 2024 and used prediction study risk...
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| Language: | English |
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BMJ Publishing Group
2025-02-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/12/1/e003147.full |
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| author | Yihun Mulugeta Alemu Sisay Mulugeta Alemu Dan Chateau Nasser Bagheri Kinley Wangdi |
| author_facet | Yihun Mulugeta Alemu Sisay Mulugeta Alemu Dan Chateau Nasser Bagheri Kinley Wangdi |
| author_sort | Yihun Mulugeta Alemu |
| collection | DOAJ |
| description | Background and objective This review compares non-laboratory-based and laboratory-based cardiovascular disease (CVD) risk prediction equations in populations targeted for primary prevention.Design Systematic review.Methods We searched five databases until 12 March 2024 and used prediction study risk of bias assessment tool to assess bias. Data on hazard ratios (HRs), discrimination (paired c-statistics) and calibration were extracted. Differences in c-statistics and HRs were analysed. Protocol: PROSPERO (CRD42021291936).Results Nine studies (1 238 562 participants, 46 cohorts) identified six unique CVD risk equations. Laboratory predictors (eg, cholesterol and diabetes) had strong HRs, while body mass index in non-laboratory models showed limited effect. Median c-statistics were 0.74 for both models (IQR: lab 0.77–0.72; non-lab 0.76–0.70), with a median absolute difference of 0.01. Calibration measures between laboratory-based and non-laboratory-based equations were similar, although non-calibrated equations often overestimated risk.Conclusion The discrimination and calibration measures between laboratory-based and non-laboratory-based models show minimal differences, demonstrating the insensitivity of c-statistics and calibration metrics to the inclusion of additional predictors. However, in most reviewed studies, the HRs for these additional predictors were substantial, significantly altering predicted risk, particularly for individuals with higher or lower levels of these predictors compared with the average. |
| format | Article |
| id | doaj-art-57592376cfe1453090fefa5974fe8a36 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
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| series | Open Heart |
| spelling | doaj-art-57592376cfe1453090fefa5974fe8a362025-02-11T09:20:10ZengBMJ Publishing GroupOpen Heart2053-36242025-02-0112110.1136/openhrt-2024-003147Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic reviewYihun Mulugeta Alemu0Sisay Mulugeta Alemu1Dan Chateau2Nasser Bagheri3Kinley Wangdi4National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, AustraliaDepartment of Health Science, University of Groningen, Groningen, The NetherlandsNational Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, AustraliaNational Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, AustraliaNational Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, AustraliaBackground and objective This review compares non-laboratory-based and laboratory-based cardiovascular disease (CVD) risk prediction equations in populations targeted for primary prevention.Design Systematic review.Methods We searched five databases until 12 March 2024 and used prediction study risk of bias assessment tool to assess bias. Data on hazard ratios (HRs), discrimination (paired c-statistics) and calibration were extracted. Differences in c-statistics and HRs were analysed. Protocol: PROSPERO (CRD42021291936).Results Nine studies (1 238 562 participants, 46 cohorts) identified six unique CVD risk equations. Laboratory predictors (eg, cholesterol and diabetes) had strong HRs, while body mass index in non-laboratory models showed limited effect. Median c-statistics were 0.74 for both models (IQR: lab 0.77–0.72; non-lab 0.76–0.70), with a median absolute difference of 0.01. Calibration measures between laboratory-based and non-laboratory-based equations were similar, although non-calibrated equations often overestimated risk.Conclusion The discrimination and calibration measures between laboratory-based and non-laboratory-based models show minimal differences, demonstrating the insensitivity of c-statistics and calibration metrics to the inclusion of additional predictors. However, in most reviewed studies, the HRs for these additional predictors were substantial, significantly altering predicted risk, particularly for individuals with higher or lower levels of these predictors compared with the average.https://openheart.bmj.com/content/12/1/e003147.full |
| spellingShingle | Yihun Mulugeta Alemu Sisay Mulugeta Alemu Dan Chateau Nasser Bagheri Kinley Wangdi Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review Open Heart |
| title | Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review |
| title_full | Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review |
| title_fullStr | Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review |
| title_full_unstemmed | Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review |
| title_short | Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review |
| title_sort | discrimination and calibration performances of non laboratory based and laboratory based cardiovascular risk predictions a systematic review |
| url | https://openheart.bmj.com/content/12/1/e003147.full |
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