A study protocol for a predictive algorithm to assess population-based premature mortality risk: Premature Mortality Population Risk Tool (PreMPoRT)

Diagnostic and Prognostic Research

Kathy Kornas¹  Meghan O’Neill¹  Lori Diemert¹  Mackenzie Hurst²  Laura C. Rosella³  Stacey Fisher³  Douglas G. Manuel⁴  Andy Hong⁵ 

[1] Dalla Lana School of Public Health, University of Toronto, 155 College St, 6th floor, M5T 3M7, Toronto, Ontario, Canada;Dalla Lana School of Public Health, University of Toronto, 155 College St, 6th floor, M5T 3M7, Toronto, Ontario, Canada;Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, M4N 3M5, Toronto, Ontario, Canada;Dalla Lana School of Public Health, University of Toronto, 155 College St, 6th floor, M5T 3M7, Toronto, Ontario, Canada;Public Health Ontario, 480 University Avenue, Suite 300, M5G 1V2, Toronto, Ontario, Canada;Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, M4N 3M5, Toronto, Ontario, Canada;Ottawa Hospital Research Institute, Ottawa, Canada;Statistics Canada, Ottawa, Canada;Department of Family Medicine, University of Ottawa, Ottawa, Canada;School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada;Bruyère Research Institute, Ottawa, Canada;University of Oxford, The George Institute for Global Health, Nuffield Department of Women’s & Reproductive Health, Hayes House, 75 George Street, OX1 2BQ, Oxford, UK;

关键词: Premature mortality;    Prediction model;    Study protocol;    Weibull model;    Population health;   

DOI  :  10.1186/s41512-020-00086-z

来源: Springer

【 摘 要 】

BackgroundPremature mortality is an important population health indicator used to assess health system functioning and to identify areas in need of health system intervention. Predicting the future incidence of premature mortality in the population can facilitate initiatives that promote equitable health policies and effective delivery of public health services. This study protocol proposes the development and validation of the Premature Mortality Risk Prediction Tool (PreMPoRT) that will predict the incidence of premature mortality using large population-based community health surveys and multivariable modeling approaches.MethodsPreMPoRT will be developed and validated using various training, validation, and test data sets generated from the six cycles of the Canadian Community Health Survey (CCHS) linked to the Canadian Vital Statistics Database from 2000 to 2017. Population-level risk factor information on demographic characteristics, health behaviors, area level measures, and other health-related factors will be used to develop PreMPoRT and to predict the incidence of premature mortality, defined as death prior to age 75, over a 5-year period. Sex-specific Weibull accelerated failure time models will be developed using a Canadian provincial derivation cohort consisting of approximately 500,000 individuals, with approximately equal proportion of males and females, and about 12,000 events of premature mortality. External validation will be performed using separate linked files (CCHS cycles 2007–2008, 2009–2010, and 2011–2012) from the development cohort (CCHS cycles 2000–2001, 2003–2004, and 2005–2006) to check the robustness of the prediction model. Measures of overall predictive performance (e.g., Nagelkerke’s R2), calibration (e.g., calibration plots), and discrimination (e.g., Harrell’s concordance statistic) will be assessed, including calibration within defined subgroups of importance to knowledge users and policymakers.DiscussionUsing routinely collected risk factor information, we anticipate that PreMPoRT will produce population-based estimates of premature mortality and will be used to inform population strategies for prevention.

【 授权许可】

CC BY