a comparative assessment of non-laboratory-based versus commonly used laboratory-based cardiovascular disease risk scores in the nhanes iii population比较non-laboratory-based与常用的实验室评估心血管疾病风险得分nhanes iii人口.pdfVIP

A Comparative Assessment of Non-Laboratory-Based versus Commonly Used Laboratory-Based Cardiovascular Disease Risk Scores in the NHANES III Population 1 1,2 1,3 Ankur Pandya , Milton C. Weinstein , Thomas A. Gaziano * 1 Center for Health Decision Science, Harvard School of Public Health, Boston, Massachusetts, United States of America, 2 Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, United States of America, 3 Divisions of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America Abstract Background: National and international primary CVD risk screening guidelines focus on using total CVD risk scores. Recently, we developed a non-laboratory-based CVD risk score (inputs: age, sex, smoking, diabetes, systolic blood pressure, treatment of hypertension, body-mass index), which can assess risk faster and at lower costs compared to laboratory-based scores (inputs include cholesterol values). We aimed to assess the exchangeability of the non-laboratory-based risk score to four commonly used laboratory-based scores (Framingham CVD [2008, 1991 versions], and Systematic COronary Risk Evaluation [SCORE] for low and high risk settings) in an external validation population. Methods and Findings: Analyses were based on individual-level, score-specific rankings of risk for adults in the Third National Health and Nutrition Examination Survey (NHANES III) aged 25–74 years, without history of CVD or cancer (n = 5,999). Risk characterization agreement was based on overlap in dichotomous risk characterization (thresholds of 10- year risk .10–20%) and Spearman rank co