Titre :
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Predicting cardiovascular events using three stage Discriminant Function is much more accurate than Framingham or QRISK. (2011)
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Auteurs :
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WALTER MARSH (Reginald) : NZL. Faculty of Medical and Health Sciences. Clinical School. Auckland University. Hamilton.
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Type de document :
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Article
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Dans :
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European journal of epidemiology (vol. 26, n° 12, 2011)
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Pagination :
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915-918
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Langues:
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Anglais
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Mots-clés :
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Appareil cardiovasculaire
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Incidence
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Homme
;
Epidémiologie
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Résumé :
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[BDSP. Notice produite par INIST-CNRS R0xoElDF. Diffusion soumise à autorisation]. The two best known approaches to predicting cardiovascular risk are Framingham and QRISK. Both methods correctly predict less than 70 % of cases, with a high ratio of false positive predictions to true predictions. Each uses a combination of predictors that is applied to the data only once. The present approach uses the Discriminant Function with multiple applications. A British sample of data on cardiovascular risk was analysed. Principal Components analysis was used to reveal the underlying structure of the data-it identified four independent determinants of the data. Discriminant Function analysis in three stages was then used to accommodate the difficulties of dealing with multiple determinants. Ninety-four percent of the cases with cardiovascular incidents (CVI) were predicted correctly up to more than 20 years ahead, with a misclassification rate overall of 2.8 errors for every one correct. When checked for likely shrinkage from sample to sample using the Jacknife method 92 % of CVI's were correctly predicted. Instead of a single application of a linear combination of predictors to find those people most likely to have cardiovascular events a repeated application of the predictors to the residuals from the previous prediction stage is likely to find a much higher proportion of true predictions and with much less error. The results also allow for a simple way of conveying the risk of CVI to individual patients.
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