A Comparative Assessment of Non-Laboratory-Based versus Commonly Used Laboratory-Based Cardiovascular Disease Risk Scores in the NHANES III Population
2011

Comparing Non-Laboratory-Based and Laboratory-Based Cardiovascular Disease Risk Scores

Sample size: 5999 publication 10 minutes Evidence: moderate

Author Information

Author(s): Ankur Pandya, Milton C. Weinstein, Thomas A. Gaziano, Murielle Bochud

Primary Institution: Harvard School of Public Health

Hypothesis

Can a non-laboratory-based cardiovascular disease risk score effectively assess risk compared to commonly used laboratory-based scores?

Conclusion

The non-laboratory-based score can serve as a useful proxy for laboratory-based scores in assessing cardiovascular disease risk.

Supporting Evidence

  • Over 91% of men and 94% of women were equivalently characterized as high or low risk by both non-laboratory-based and laboratory-based scores.
  • The non-laboratory-based score had a c-statistic of 0.782 for men and 0.809 for women, indicating good discrimination of CVD risk.
  • Statistical analysis showed no significant differences in risk prediction for men, while women showed a significant difference in c-statistics between the non-laboratory-based and Framingham scores.

Takeaway

This study shows that a simple risk score that doesn't need lab tests can help doctors figure out who is at risk for heart problems, just like more complicated tests.

Methodology

The study analyzed individual-level risk scores from the NHANES III dataset, comparing a non-laboratory-based score to four laboratory-based scores using statistical methods including Spearman correlation and ROC curve analysis.

Potential Biases

Potential bias due to the reliance on imputed data for missing values.

Limitations

The study was limited by the use of cause-specific mortality data, which restricted the ability to assess calibration of the risk scores.

Participant Demographics

Participants were adults aged 25-74 years, with a sample of 5,999 individuals without a history of cardiovascular disease or cancer.

Statistical Information

P-Value

0.04

Confidence Interval

(0.739–0.825)

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0020416

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