| Titre : | Clinical Usefulness of the Framingham Cardiovascular Risk Profile Beyond Its Statistical Performance : The Tehran Lipid and Glucose Study. (2012) |
| Auteurs : | Davood KHALILI ; AZIZI (Fereidoun) : IRN. Endocrine Research Center. Research Institute for Endocrine Sciences. Shahid Beheshti University of Medical Sciences. Tehran. ; Mohammadreza BOZORGMANESH ; Farzad HADAEGH ; SOORI (Hamid) : IRN. Safety Promotion and Injury Prevention Research Center. Shahid Beheshti University of Medical Sciences. Tehran. ; STEYERBERG (Ewout-W) : NLD. Department of Public Health. Erasmus Medical Center. Rotterdam. ; Department of Epidemiology. School of Public Health. Shahid Beheshti University of Medical Sciences. Tehran. IRN ; Prevention of Metabolic Disorders Research Center. Research Institute for Endocrine Sciences. Shahid Beheshti University of Medical Sciences. Tehran. IRN |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 176, n° 3, 2012) |
| Pagination : | 177-186 |
| Langues: | Anglais |
| Mots-clés : | Facteur risque ; Statistique ; Performance ; Iran ; Lipide ; Glucose ; Décision ; Epidémiologie ; Prévision ; Estimation ; Modèle ; Asie |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xsFttG. Diffusion soumise à autorisation]. The utility of a risk function in clinical practice is an important concept that has received insufficient attention. The authors evaluated the clinical usefulness of the Framingham risk function (FRF) for cardiovascular disease in a Middle Eastern population (2,640 men and 3,584 women aged 30-74 years) free of cardiovascular disease at baseline in 1999. They calculated the net benefit fraction for treatment of subjects with an estimated 10-year risk of>10% and also>=20%, where the net benefit fraction is a weighted sum of true-positive and false-positive rates divided by incidence, as estimated by Kaplan-Meier analysis. The authors drew a decision curve by plotting the net benefit fraction against a wide range of risk thresholds for treatment. The cumulative incidence of cardiovascular disease was 7.6% and 12.3% in women and men, respectively. The FRF had a C index of 0.832 in women and 0.785 in men with a reasonable calibration. On the basis of the net benefit fraction, about 50% of the incidence in men and women could be appropriately treated by using the 10% threshold ; however, the FRF was not useful at the 20% threshold, especially in women. In both genders, usefulness of the FRF was as good as the function derived directly from Tehrani data with the same variables ; however, it could be useful in low thresholds for treatment. |
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