Tran-Duy, A and McDermott, R and Knight, J and Hua, X and Barr, ELM and Arabena, K and Palmer, AJ and Clarke, PM, Development and use of prediction models for classification of cardiovascular risk of remote indigenous Australians, Heart Lung and Circulation pp. 1-10. ISSN 1443-9506 (2019) [Refereed Article]
Copyright 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) https://creativecommons.org/licenses/by-nc-nd/4.0/
Methods: We used clinical and demographic information on Indigenous people aged between 30 and 74 years without a history of CVD events who participated in the Well Person's Health Check (WPHC), a community-based survey. Baseline assessments were conducted between 1998 and 2000, and data were linked to administrative hospitalisation and death records for identification of CVD events. We used Cox proportional hazard models to estimate the 5-year CVD risk, and the Harrell's c-statistic and the modified Hosmer-Lemeshow (mH-L) χ2 statistic to assess the model discrimination and calibration, respectively.
Results: The study sample consisted of 1,583 individuals (48.1% male; mean age 45.0 year). The risk score consisted of sex, age, systolic blood pressure, diabetes mellitus, waist circumference, triglycerides, and albumin creatinine ratio. The bias-corrected c-statistic was 0.72 and the bias-corrected mH-L χ2 statistic was 12.01 (p-value, 0.212), indicating good discrimination and calibration, respectively. Using our risk score, the CVD risk of the Indigenous Australians could be stratified to a greater degree compared to a recalibrated Framingham risk score.
Conclusions: A seven-factor risk score could satisfactorily stratify 5-year risk of CVD in an Indigenous Australian cohort. These findings inform future research targeting CVD risk in Indigenous Australians.
|Item Type:||Refereed Article|
|Keywords:||aboriginal, cardiovascular disease, coronary heart disease, prediction model, risk score, Torres Strait Islanders|
|Research Division:||Medical and Health Sciences|
|Research Group:||Cardiorespiratory Medicine and Haematology|
|Research Field:||Cardiology (incl. Cardiovascular Diseases)|
|Objective Group:||Indigenous Health|
|Objective Field:||Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions)|
|UTAS Author:||Palmer, AJ (Professor Andrew Palmer)|
|Deposited By:||Menzies Institute for Medical Research|
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