Development,validation and comparison of multivariable risk scores for prediction of total stroke and stroke types in Chinese adults:a prospective study of 0.5 million adults
作者机构：Clinical Trial Service Unit and Epidemiological StudiesNuffield Department of Population HealthUniversity of OxfordOxfordUK Department of Engineering ScienceUniversity of OxfordOxfordUK Department of Biomedical EngineeringOxford-Suzhou Centre for Advanced ResearchSuzhouChina Medical Research Council Health Research UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK CKB Project DepartmentFuwai Hospital Chinese Academy of Medical SciencesNational Center for Cardiovascular DiseasesBeijingChina CKB Project DepartmentChinese Academy of Medical SciencesBeijingChina Department of Epidemiology and BiostatisticsSchool of Public HealthPeking UniversityBeijingChina Department of EpidemiologyPeking University Center for Public Health and Epidemic Preparedness and ResponseBeijingChina On behalf of the China Kadoorie Biobank Collaborative Group
出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)
年 卷 期：2022年第7卷第4期
页 面：328-336,I0023-I0045页
核心收录：
学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学]
基 金：funded by the Kadoorie Charitable Foundation,Hong Kong,China and the funding sources for the long-term continuation of the study included UK Wellcome Trust(202922/Z/16/Z,104085/Z/14/Z,088158/Z/09/Z) Chinese National Natural Science Foundation(81390540,81390541,81390544) the National Key Research and Development Program of China(2016YFC0900500,2016YFC0900501,2016YFC0900504,2016YFC1303904).Core funding was also provided to the CTSU,University of Oxford,by the British Heart Foundation(CH/1996001/9454) the UK Medical Research Council,and Cancer Research UK.MC was supported by a Rhodes Scholarship.BJC was supported by a Nuffield Department of Population Health Senior Research Fellowship.The University of Oxford Medical Research Council(MRC)Population Health Research Unit is funded through a strategic partnership between the MRC and the University of Oxford(MC_UU_00017/1,MC_UU_12026/2,MC_U137686851) The research was also supported by the National Institute for Health Research(NIHR)Oxford Biomedical Research Centre(BRC)
主 题：prediction income absolute
摘 要：Background and purpose Low-income and middle-income countries have the greatest stroke burden,yet remain *** study compared the utility of Framingham versus novel risk scores for prediction of total stroke and stroke types in Chinese *** China Kadoorie Biobank(CKB)is a prospective study of 512726 adults,aged 30-79 years,recruited from 10 areas in China in *** 1 January 2018,43234 incident first stroke cases(36310 ischaemic stroke(IS);8865 haemorrhagic stroke(HS))were recorded in 503842 participants with no history of stroke at *** compared the predictive utility of the Framingham Stroke Risk Profile(FSRP)with novel CKB stroke risk scores and included recalibration,refitting,stratifying by study area and addition of other risk *** was assessed using area under the receiver operating characteristic curve(AUC)and calibration was assessed using Greenwood-Nam-D’Agostinoχ^(2) *** Incidence of total stroke varied fivefold by area in *** FSRP had good discrimination for total stroke(AUC(95%CI);men:0.78(0.77 to 0.79),women:0.77(95%CI 0.76 to 0.78)),but poor calibration(χ^(2);men:1,825,women:3,053),substantially underestimating absolute *** reducedχ^(2) by80%,but did not improve *** the FSRP did not materially improve discrimination,but further improved *** by area improved discrimination(AUC;men:0.82(0.82 to 0.83);women:0.82(0.82 to 0.83)),but not *** other risk factors yielded modest,but statistically significant,improvements in the *** findings for IS and HS were similar to those for total *** The FSRP reliably differentiated Chinese adults with incident stroke,but substantially underestimated the absolute risks of *** local risk prediction equations that took account of differences in stroke incidence within China enhanced risk prediction of total stroke and major stroke pathological type
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