dc.contributor.author
Piccininni, Marco
dc.contributor.author
Rohmann, Jessica Lee
dc.contributor.author
Huscher, Dörte
dc.contributor.author
Mielke, Nina
dc.contributor.author
Ebert, Natalie
dc.contributor.author
Logroscino, Giancarlo
dc.contributor.author
Schäffner, Elke
dc.contributor.author
Kurth, Tobias
dc.date.accessioned
2020-07-27T08:14:12Z
dc.date.available
2020-07-27T08:14:12Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/27867
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-27620
dc.description.abstract
Background: European guidelines recommend the use of the Systematic COronary Risk Evaluation (SCORE) to assess 10-year risk of fatal cardiovascular events in people aged 40 to 65. The SCORE Older Persons (SCORE OP, 5-year and 10-year versions) was recently developed for people aged 65 or older. We assessed the performance of these risk scores in predicting fatal cardiovascular events in older persons in Berlin.
Methods and findings: Data from the Berlin Initiative Study (BIS), a prospective, population-based study of older persons recruited from a German public health insurance company database were used. 1,657 participants aged 70 or older without reported previous myocardial infarction were included. We assessed calibration by comparing predicted risks to observed (for 5-year versions, 5y) or projected (for 10-year versions) probabilities. During follow-up (median: 4.8 years), 118 cardiovascular deaths occurred. The calibration assessment of the SCORE OP-H 5y and SCORE OP-L 5y equations revealed 2.1- and 1.5-fold overestimation. Comparing 10-year versions, the SCORE OP showed better discrimination ability compared to the SCORE (C-indices of around 0.80 compared to 0.72) and the SCORE for high-risk regions showed the best calibration (chi-square = 29.68). The SCORE OP overestimated the true risk; 519 and 677 events were predicted using the low-risk and high-risk region SCORE OP equations compared to 397 to 399 events projected based on BIS follow-up data (predicted/actual ratios of 1.3 and 1.7).
Conclusions: Given the low transportability of the SCORE OP observed in our population, we caution against its use in routine clinical practice until further information is available to avoid possible overtreatment among older persons in Berlin.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Cardiovascular Diseases
en
dc.subject
Kaplan-Meier Estimate
en
dc.subject
Reproducibility of Results
en
dc.subject
Risk Assessment
en
dc.subject
Risk Factors
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Performance of risk prediction scores for cardiovascular mortality in older persons: External validation of the SCORE OP and appraisal
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
e0231097
dcterms.bibliographicCitation.doi
10.1371/journal.pone.0231097
dcterms.bibliographicCitation.journaltitle
PLoS ONE
dcterms.bibliographicCitation.number
4
dcterms.bibliographicCitation.originalpublishername
Public Library of Science (PLoS)
dcterms.bibliographicCitation.volume
15
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dc.relation.hascorrection
https://doi.org/10.17169/refubium-27866
dcterms.bibliographicCitation.pmid
32271825
dcterms.isPartOf.eissn
1932-6203