gms | German Medical Science

49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI)
Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Schweizerische Gesellschaft für Medizinische Informatik (SGMI)

26. bis 30.09.2004, Innsbruck/Tirol

Predictive Accuracy of the SCORE Risk Function for Cardiovascular Disease in Austrian Men and Women

Meeting Abstract (gmds2004)

  • corresponding author presenting/speaker Hanno Ulmer - Institut für Biostatistik und Dokumentation, Medizinische Universität Innsbruck, Innsbruck, Österreich
  • Barbara Kollerits - Institut für Biostatistik und Dokumentation, Medizinische Universität Innsbruck, Innsbruck, Österreich
  • Cecily Kelleher - Department of Public Health Medicine and Epidemiology, University College Dublin, Dublin, Irland
  • Günter Diem - Arbeitskreis für Vorsorge- und Sozialmedizin, Bregenz, Österreich
  • Hans Concin - Arbeitskreis für Vorsorge- und Sozialmedizin, Bregenz, Österreich

Kooperative Versorgung - Vernetzte Forschung - Ubiquitäre Information. 49. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 19. Jahrestagung der Schweizerischen Gesellschaft für Medizinische Informatik (SGMI) und Jahrestagung 2004 des Arbeitskreises Medizinische Informatik (ÖAKMI) der Österreichischen Computer Gesellschaft (OCG) und der Österreichischen Gesellschaft für Biomedizinische Technik (ÖGBMT). Innsbruck, 26.-30.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04gmds140

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/gmds2004/04gmds140.shtml

Published: September 14, 2004

© 2004 Ulmer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction

In 2003, a new risk scoring system for cardiovascular risk in clinical practice was developed by the SCORE project group, who assembled a pool of datasets from 12 European cohort studies in order to calculate separate risk functions for high- and low risk regions of Europe [1]. The aim of this paper is to evaluate the predictive accuracy of the SCORE risk functions in a large prospectively observed population of Austrian men and women.

Methods

Using the different SCORE functions for low risk regions, we calculated the risk of death from all cardiovascular (ICD-9 401-414, 426-443 with the exception of 426.7, 429.0, 430.0, 432.1, 437.3, 437.4 and 437.5, including 798.1 and 798.2) and coronary heart disease (CHD) events (ICD-9 410-414) over a 10 year period for 55,387 participants (23,526 men and 31,861 women) in the Vorarlberg Health Monitoring & Promotion Programme (VHM&PP) [2], [3]. The predicted risks were then compared with the estimated 95% confidence intervals of the observed events.

Results

There were 637 (1.15%; 95%CI 1.06-1.24) fatal CHD events, 357 (1.52% 95%CI 1.36-1.68) in men and 280 (0.88% 95%CI 0.78-0.99) in women. This compared to 699 events (1.26%) predicted (relative overestimation overall 9.57%, p<0.05), 413 (1.76%) in men and 286 (0.90%) in women (15.79% relative overestimation in men, p<0.05, 2.27% in women).

We further observed a total of 1134 deaths (2.05% 95%CI 1.93-2.17) for all cardiovascular disease (including CHD), 591 (2.51% 95%CI 2.32-2.72) in men and 543 (1.7% 95%CI 1.57-1.85) in women. The SCORE function predicted 1152 (2.08%) events, 609 (2.59%) in men and 543 (1.7%) in women (3.19% relative overestimation in men).

Discussion

The recently developed SCORE risk function for low risk regions proved an appropriate tool for cardiovascular risk estimation in Austria. However, there was a significant degree of overestimation of coronary heart disease mortality in men. Possible reasons for this, including secular trends and other potentially confounding risk factors will be explored, together with a discussion of methodological problems regarding the estimation and between-cohort comparison of cardiovascular risk scores.


References

1.
Conroy RM, Pyorala K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetiere P, Jousilahti P, Keil U, Njolstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM on behalf of the SCORE project group. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003; 24(11): 987-1003.
2.
Ulmer H, Kelleher C, Diem G, Concin H. Long-term tracking of cardiovascular risk factors among men and women in a large population-based health system: the Vorarlberg Health Monitoring & Promotion Programme. Eur Heart J. 2003; 24(11):1004-13.
3.
Ulmer H, Kelleher C, Diem G, Concin H. Why Eve is not Adam. Prospective follow-up in 149,650 women and men of cholesterol and other risk factors related to cardiovascular and all-cause mortality. Journal of Women`s Health. 2004;13:41-54.