Prediction of Long-Term Incidence of Chronic Cardiovascular and Cardiopulmonary Diseases in Primary Care Patients for Population Health Monitoring: The Intermountain Chronic Disease Model (ICHRON).
Mayo Clin Proc
; 94(7): 1221-1230, 2019 07.
Article
en En
| MEDLINE
| ID: mdl-30577973
ABSTRACT
OBJECTIVE:
To apply the practical parsimonious modeling method of the Intermountain Mortality Risk Score in a primary care environment to predict chronic disease (ChrD) onset. PATIENTS ANDMETHODS:
Primary care patients free of ChrD (women n=98,711; men n=45,543) were evaluated to develop (70% [n=95,882] of patients) and validate (the other 30% [n=48,372]) the sex-specific Intermountain Chronic Disease Risk Score (ICHRON) if seen initially between January 1, 2003, and December 31, 2005. The sex-specific ICHRON was composed of comprehensive metabolic profile and complete blood count components and age. The primary outcome was the first diagnosis of coronary artery disease, myocardial infarction, heart failure, atrial fibrillation, stroke, diabetes, renal failure, chronic obstructive pulmonary disease, peripheral vascular disease, or dementia within 3 years of baseline.RESULTS:
At 3 years, 9.0% of men (mean age, 44±16 years) and 6.6% of women (mean age, 42±16 years) received a diagnosis of ChrD. In the derivation population, C-statistics were 0.783 (95% CI, 0.774-0.791) for men and 0.774 (95% CI, 0.767-0.781) for women. In the validation population, C-statistics were 0.774 (95% CI, 0.762-0.786) for men and 0.762 (95% CI, 0.752-0.772) for women. Evaluation of 10-year outcomes for ICHRON and analysis of its association with each outcome individually at 3 years revealed similar predictive ability.CONCLUSION:
An augmented intelligence clinical decision tool for primary care, ICHRON, is developed using common laboratory parameters, which provides good discrimination of ChrD risk at 3 and 10 years.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Atención Primaria de Salud
/
Enfermedad Crónica
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Valor Predictivo de las Pruebas
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Enfermedad Pulmonar Obstructiva Crónica
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Salud Poblacional
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Cardiopatías
Tipo de estudio:
Incidence_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Mayo Clin Proc
Año:
2019
Tipo del documento:
Article