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Validation of the UKPDS 82 risk equations within the Cardiff Diabetes Model.

McEwan P, Ward T, Bennett H, Bergenheim K - Cost Eff Resour Alloc (2015)

Bottom Line: Results stratified by internal and external validation studies produced MAPE of 43.77 and 37.82%, respectively, when using UKPDS 82, and MAPE of 40.49 and 53.92%, respectively when using UKPDS 68.Areas of lack of fit, as measured by MAPE were inconsistent between sets of equations with ACCORD demonstrating a noteworthy lack of fit with UKPPDS 68 (MAPE = 170.88%) and the ADDITION study for UKPDS 82 (MAPE = 89.90%).This study has demonstrated that the UKPDS 82 equations exhibit similar levels of external validity to the UKPDS 68 equations with the additional benefit of enabling more diabetes related endpoints to be modeled.

View Article: PubMed Central - PubMed

Affiliation: Health Economics and Outcomes Research Ltd, Cardiff, UK ; Centre for Health Economics, Swansea University, Swansea, UK.

ABSTRACT

Background: For end-users of diabetes models that include UKPDS 82 risk equations, an important question is how well these new equations perform. Consequently, the principal objective of this study was to validate the UKPDS 82 risk equations, embedded within an established type 2 diabetes mellitus (T2DM) model, the Cardiff Diabetes Model, to contemporary T2DM outcomes studies.

Methods: A total of 100 validation endpoints were simulated across treatment arms of twelve pivotal T2DM outcomes studies, simulation cohorts representing each validation study's cohort profile were generated and intensive and conventional treatment arms were defined in the Cardiff Diabetes Model.

Results: Overall the validation coefficient of determination was similar between both sets of risk equations: UKPDS 68, R(2) = 0.851; UKPDS 82, R(2) = 0.870. Results stratified by internal and external validation studies produced MAPE of 43.77 and 37.82%, respectively, when using UKPDS 82, and MAPE of 40.49 and 53.92%, respectively when using UKPDS 68. Areas of lack of fit, as measured by MAPE were inconsistent between sets of equations with ACCORD demonstrating a noteworthy lack of fit with UKPPDS 68 (MAPE = 170.88%) and the ADDITION study for UKPDS 82 (MAPE = 89.90%).

Conclusions: This study has demonstrated that the UKPDS 82 equations exhibit similar levels of external validity to the UKPDS 68 equations with the additional benefit of enabling more diabetes related endpoints to be modeled.

No MeSH data available.


Related in: MedlinePlus

Observed versus predicted endpoints stratified by validations study, endpoint and UKPDS equations. Overall validation coefficient of determination for UKPDS 68, R2 = 0.851; UKPDS 82, R2 = 0.870. ACM all-cause mortality, CHF congestive heart failure, CHD coronary heart disease, CV cardiovascular, MI myocardial infarction, ESRD end stage renal disease, MVD microvascular disease, PE primary endpoint.
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Fig1: Observed versus predicted endpoints stratified by validations study, endpoint and UKPDS equations. Overall validation coefficient of determination for UKPDS 68, R2 = 0.851; UKPDS 82, R2 = 0.870. ACM all-cause mortality, CHF congestive heart failure, CHD coronary heart disease, CV cardiovascular, MI myocardial infarction, ESRD end stage renal disease, MVD microvascular disease, PE primary endpoint.

Mentions: A total of 100 validation endpoints were simulated across treatment arms of twelve pivotal T2DM outcomes studies. Results from assessing overall goodness of fit via linear regression modeling to the annualized event rate is presented in Table 1. On average both sets of equations tended to slightly under predict the observed event rate as indicated by the intercept terms reported in Table 1; 3.6 (p < 0.001) for UKPDS 68 and 2.4 (p = 0.056) for UKPDS 82. The borderline non-significant intercept term and slope coefficient for UKPDS 82 indicated a slight improvement in fit compared to UKPDS 68. Across all stratifications, the R2 statistic showed high degrees of linear correlation between observed and predicted and points. Figure 1 illustrates the relationship between study observed versus predicted endpoints stratified by validations study, endpoint and UKPDS equations. Overall the validation coefficient of determination was similar between both sets of equations: UKPDS 68, R2 = 0.851; UKPDS 82, R2 = 0.870.Table 1


Validation of the UKPDS 82 risk equations within the Cardiff Diabetes Model.

McEwan P, Ward T, Bennett H, Bergenheim K - Cost Eff Resour Alloc (2015)

Observed versus predicted endpoints stratified by validations study, endpoint and UKPDS equations. Overall validation coefficient of determination for UKPDS 68, R2 = 0.851; UKPDS 82, R2 = 0.870. ACM all-cause mortality, CHF congestive heart failure, CHD coronary heart disease, CV cardiovascular, MI myocardial infarction, ESRD end stage renal disease, MVD microvascular disease, PE primary endpoint.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4524168&req=5

Fig1: Observed versus predicted endpoints stratified by validations study, endpoint and UKPDS equations. Overall validation coefficient of determination for UKPDS 68, R2 = 0.851; UKPDS 82, R2 = 0.870. ACM all-cause mortality, CHF congestive heart failure, CHD coronary heart disease, CV cardiovascular, MI myocardial infarction, ESRD end stage renal disease, MVD microvascular disease, PE primary endpoint.
Mentions: A total of 100 validation endpoints were simulated across treatment arms of twelve pivotal T2DM outcomes studies. Results from assessing overall goodness of fit via linear regression modeling to the annualized event rate is presented in Table 1. On average both sets of equations tended to slightly under predict the observed event rate as indicated by the intercept terms reported in Table 1; 3.6 (p < 0.001) for UKPDS 68 and 2.4 (p = 0.056) for UKPDS 82. The borderline non-significant intercept term and slope coefficient for UKPDS 82 indicated a slight improvement in fit compared to UKPDS 68. Across all stratifications, the R2 statistic showed high degrees of linear correlation between observed and predicted and points. Figure 1 illustrates the relationship between study observed versus predicted endpoints stratified by validations study, endpoint and UKPDS equations. Overall the validation coefficient of determination was similar between both sets of equations: UKPDS 68, R2 = 0.851; UKPDS 82, R2 = 0.870.Table 1

Bottom Line: Results stratified by internal and external validation studies produced MAPE of 43.77 and 37.82%, respectively, when using UKPDS 82, and MAPE of 40.49 and 53.92%, respectively when using UKPDS 68.Areas of lack of fit, as measured by MAPE were inconsistent between sets of equations with ACCORD demonstrating a noteworthy lack of fit with UKPPDS 68 (MAPE = 170.88%) and the ADDITION study for UKPDS 82 (MAPE = 89.90%).This study has demonstrated that the UKPDS 82 equations exhibit similar levels of external validity to the UKPDS 68 equations with the additional benefit of enabling more diabetes related endpoints to be modeled.

View Article: PubMed Central - PubMed

Affiliation: Health Economics and Outcomes Research Ltd, Cardiff, UK ; Centre for Health Economics, Swansea University, Swansea, UK.

ABSTRACT

Background: For end-users of diabetes models that include UKPDS 82 risk equations, an important question is how well these new equations perform. Consequently, the principal objective of this study was to validate the UKPDS 82 risk equations, embedded within an established type 2 diabetes mellitus (T2DM) model, the Cardiff Diabetes Model, to contemporary T2DM outcomes studies.

Methods: A total of 100 validation endpoints were simulated across treatment arms of twelve pivotal T2DM outcomes studies, simulation cohorts representing each validation study's cohort profile were generated and intensive and conventional treatment arms were defined in the Cardiff Diabetes Model.

Results: Overall the validation coefficient of determination was similar between both sets of risk equations: UKPDS 68, R(2) = 0.851; UKPDS 82, R(2) = 0.870. Results stratified by internal and external validation studies produced MAPE of 43.77 and 37.82%, respectively, when using UKPDS 82, and MAPE of 40.49 and 53.92%, respectively when using UKPDS 68. Areas of lack of fit, as measured by MAPE were inconsistent between sets of equations with ACCORD demonstrating a noteworthy lack of fit with UKPPDS 68 (MAPE = 170.88%) and the ADDITION study for UKPDS 82 (MAPE = 89.90%).

Conclusions: This study has demonstrated that the UKPDS 82 equations exhibit similar levels of external validity to the UKPDS 68 equations with the additional benefit of enabling more diabetes related endpoints to be modeled.

No MeSH data available.


Related in: MedlinePlus