scholarly journals Prediction of coronary heart disease in rural Chinese adults: a cross sectional study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12259
Author(s):  
Qian Wang ◽  
Wenxing Li ◽  
Yongbin Wang ◽  
Huijun Li ◽  
Desheng Zhai ◽  
...  

Background Coronary heart disease (CHD) is a common cardiovascular disease with high morbidity and mortality in China. The CHD risk prediction model has a great value in early prevention and diagnosis. Methods In this study, CHD risk prediction models among rural residents in Xinxiang County were constructed using Random Forest (RF), Support Vector Machine (SVM), and the least absolute shrinkage and selection operator (LASSO) regression algorithms with identified 16 influencing factors. Results Results demonstrated that the CHD model using the RF classifier performed best both on the training set and test set, with the highest area under the curve (AUC = 1 and 0.9711), accuracy (one and 0.9389), sensitivity (one and 0.8725), specificity (one and 0.9771), precision (one and 0.9563), F1-score (one and 0.9125), and Matthews correlation coefficient (MCC = one and 0.8678), followed by the SVM (AUC = 0.9860 and 0.9589) and the LASSO classifier (AUC = 0.9733 and 0.9587). Besides, the RF model also had an increase in the net reclassification index (NRI) and integrated discrimination improvement (IDI) values, and achieved a greater net benefit in the decision curve analysis (DCA) compared with the SVM and LASSO models. Conclusion The CHD risk prediction model constructed by the RF algorithm in this study is conducive to the early diagnosis of CHD in rural residents of Xinxiang County, Henan Province.

Author(s):  
Sang Hoon Woo ◽  
Arturo J. Rios-Diaz ◽  
Alan A. Kubey ◽  
Dianna R. Cheney-Peters ◽  
Lily L. Ackermann ◽  
...  

Background: Coronavirus disease 2019 (COVID-19) carries high morbidity and mortality globally. Identification of patients at risk for clinical deterioration upon presentation would aid in triaging, prognostication, and allocation of resources and experimental treatments. Research Question: Can we develop and validate a web-based risk prediction model for identification of patients who may develop severe COVID-19, defined as intensive care unit (ICU) admission, mechanical ventilation, and/or death? Methods: This retrospective cohort study reviewed 415 patients admitted to a large urban academic medical center and community hospitals. Covariates included demographic, clinical, and laboratory data. The independent association of predictors with severe COVID-19 was determined using multivariable logistic regression. A derivation cohort (n=311, 75%) was used to develop the prediction models. The models were tested by a validation cohort (n=104, 25%). Results: The median age was 66 years (Interquartile range [IQR] 54-77) and the majority were male (55%) and non-White (65.8%). The 14-day severe COVID-19 rate was 39.3%; 31.7% required ICU, 24.6% mechanical ventilation, and 21.2% died. Machine learning algorithms and clinical judgment were used to improve model performance and clinical utility, resulting in the selection of eight predictors: age, sex, dyspnea, diabetes mellitus, troponin, C-reactive protein, D-dimer, and aspartate aminotransferase. The discriminative ability was excellent for both the severe COVID-19 (training area under the curve [AUC]=0.82, validation AUC=0.82) and mortality (training AUC= 0.85, validation AUC=0.81) models. These models were incorporated into a mobile-friendly website. Interpretation: This web-based risk prediction model can be used at the bedside for prediction of severe COVID-19 using data mostly available at the time of presentation.


2017 ◽  
Vol 125 ◽  
pp. 02071 ◽  
Author(s):  
Jostinah Lam ◽  
Eko Supriyanto ◽  
Faris Yahya ◽  
Muhammad Haikal Satria ◽  
Suhaini Kadiman ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Ying Dong ◽  
Yajun Shi ◽  
Jinli Wang ◽  
Qing Dan ◽  
Ling Gao ◽  
...  

Background. Sudden cardiac death is a leading cause of death from coronary heart disease (CHD). The risk of sudden cardiac death (SCD) increases with age, and sudden arrhythmic death remains a major cause of mortality in elderly individuals, especially ventricular arrhythmias (VA). We developed a risk prediction model by combining ECG and other clinical noninvasive indexes including biomarkers and echocardiology for VA in elderly patients with CHD. Method. In the retrospective study, a total of 2231 consecutive elderly patients (≥60 years old) with CHD hospitalized were investigated, and finally 1983 patients were enrolled as the model group. The occurrence of VA within 12 months was mainly collected. Study parameters included clinical characteristics (age, gender, height, weight, BMI, and past medical history), ECG indexes (QTcd, Tp-e/QT, and HRV indexes), biomarker indexes (NT-proBNP, Myo, cTnT, CK-MB, CRP, K+, and Ca2+), and echocardiology indexes. In the respective study, 406 elderly patients (≥60 years old) with CHD were included as the verification group to verify the model in terms of differentiation and calibration. Results. In the multiparameter model, seven independent predictors were selected: LVEF, LAV, HLP, QTcd, sex, Tp-e/QT, and age. Increased HLP, Tp-e/QT, QTcd, age, and LAV were risk factors (RR > 1), while female and increased LVEF were protective factors (RR < 1). This model can well predict the occurrence of VA in elderly patients with CHD (for model group, AUC: 0.721, 95% CI: 0.669∼0.772; for verification group, AUC: 0.73, 95% CI: 0.648∼0.818; Hosmer–Lemeshow χ 2  = 13.541, P = 0.095 ). After adjusting the predictors, it was found that the combination of clinical indexes and ECG indexes could predict VA more efficiently than using clinical indexes alone. Conclusions. LVEF, LAV, QTcd, Tp-e/QT, gender, age, and HLP were independent predictors of VA risk in elderly patients with CHD. Among these factors, the echocardiology indexes LVEF and LAV had the greatest influence on the predictive efficiency of the model, followed by ECG indexes, QTcd and Tp-e/QT. After verification, the model had a good degree of differentiation and calibration, which can provide a certain reference for clinical prediction of the VA occurrence in elderly patients with CHD.


Author(s):  
Guizhou Hu ◽  
Martin M. Root

Background No methodology is currently available to allow the combining of individual risk factor information derived from different longitudinal studies for a chronic disease in a multivariate fashion. This paper introduces such a methodology, named Synthesis Analysis, which is essentially a multivariate meta-analytic technique. Design The construction and validation of statistical models using available data sets. Methods and results Two analyses are presented. (1) With the same data, Synthesis Analysis produced a similar prediction model to the conventional regression approach when using the same risk variables. Synthesis Analysis produced better prediction models when additional risk variables were added. (2) A four-variable empirical logistic model for death from coronary heart disease was developed with data from the Framingham Heart Study. A synthesized prediction model with five new variables added to this empirical model was developed using Synthesis Analysis and literature information. This model was then compared with the four-variable empirical model using the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study data set. The synthesized model had significantly improved predictive power ( x2 = 43.8, P < 0.00001). Conclusions Synthesis Analysis provides a new means of developing complex disease predictive models from the medical literature.


Circulation ◽  
2008 ◽  
Vol 118 (2) ◽  
Author(s):  
Morris Schambelan ◽  
Peter W.F. Wilson ◽  
Kevin E. Yarasheski ◽  
W. Todd Cade ◽  
Victor G. Dávila-Román ◽  
...  

Author(s):  
Julie R. Palmer ◽  
Gary Zirpoli ◽  
Kimberly A. Bertrand ◽  
Tracy Battaglia ◽  
Leslie Bernstein ◽  
...  

PURPOSE Breast cancer risk prediction models are used to identify high-risk women for early detection, targeted interventions, and enrollment into prevention trials. We sought to develop and evaluate a risk prediction model for breast cancer in US Black women, suitable for use in primary care settings. METHODS Breast cancer relative risks and attributable risks were estimated using data from Black women in three US population-based case-control studies (3,468 breast cancer cases; 3,578 controls age 30-69 years) and combined with SEER age- and race-specific incidence rates, with incorporation of competing mortality, to develop an absolute risk model. The model was validated in prospective data among 51,798 participants of the Black Women's Health Study, including 1,515 who developed invasive breast cancer. A second risk prediction model was developed on the basis of estrogen receptor (ER)–specific relative risks and attributable risks. Model performance was assessed by calibration (expected/observed cases) and discriminatory accuracy (C-statistic). RESULTS The expected/observed ratio was 1.01 (95% CI, 0.95 to 1.07). Age-adjusted C-statistics were 0.58 (95% CI, 0.56 to 0.59) overall and 0.63 (95% CI, 0.58 to 0.68) among women younger than 40 years. These measures were almost identical in the model based on estrogen receptor–specific relative risks and attributable risks. CONCLUSION Discriminatory accuracy of the new model was similar to that of the most frequently used questionnaire-based breast cancer risk prediction models in White women, suggesting that effective risk stratification for Black women is now possible. This model may be especially valuable for risk stratification of young Black women, who are below the ages at which breast cancer screening is typically begun.


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