Validation of a model to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD: the rotterdam ischemic heart disease and stroke computer simulation (RISC) model

BMC Medicine

Research Article

S Matthijs Boekholdt¹  Ersen B Colkesen²  Albert Hofman³  Bob JH van Kempen⁴  Bart S Ferket⁴  MG Myriam Hunink⁵  Kay-Tee Khaw⁶  Ewout W Steyerberg⁷  Nicholas J Wareham⁸ 

[1] Department of Cardiology, Amsterdam Medical Center, Meibergdreef 9, 1150, Amsterdam, AZ, The Netherlands;Department of Cardiology, Antonius Hospital, Koekoekslaan 1, 3435, Nieuwegein, CM, The Netherlands;Department of Epidemiology, Erasmus MC Rotterdam, dr Molewaterplein 50, 3015, Rotterdam, GE, The Netherlands;Department of Epidemiology, Erasmus MC Rotterdam, dr Molewaterplein 50, 3015, Rotterdam, GE, The Netherlands;Department of Radiology, Erasmus MC Rotterdam, dr Molewaterplein 50, 3015, Rotterdam, GE, The Netherlands;Department of Epidemiology, Erasmus MC Rotterdam, dr Molewaterplein 50, 3015, Rotterdam, GE, The Netherlands;Department of Radiology, Erasmus MC Rotterdam, dr Molewaterplein 50, 3015, Rotterdam, GE, The Netherlands;Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Avenue, 02115, Boston, MA, USA;Department of Public Health and Primary Care, University of Cambridge, Robinson Way, CB2 0SR, Cambridge, UK;Department of Public Health, Erasmus MC Rotterdam, dr Molewaterplein 50, 3015, Rotterdam, GE, The Netherlands;Medical Research Council Epidemiology Unit, Hills Road, CB2 0QQ, Cambridge, UK;

关键词: Cardiovascular disease prevention;    Simulation modeling;    Model validation;   

DOI  :  10.1186/1741-7015-10-158

 received in 2012-04-24, accepted in 2012-12-06,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundWe developed a Monte Carlo Markov model designed to investigate the effects of modifying cardiovascular disease (CVD) risk factors on the burden of CVD. Internal, predictive, and external validity of the model have not yet been established.MethodsThe Rotterdam Ischemic Heart Disease and Stroke Computer Simulation (RISC) model was developed using data covering 5 years of follow-up from the Rotterdam Study. To prove 1) internal and 2) predictive validity, the incidences of coronary heart disease (CHD), stroke, CVD death, and non-CVD death simulated by the model over a 13-year period were compared with those recorded for 3,478 participants in the Rotterdam Study with at least 13 years of follow-up. 3) External validity was verified using 10 years of follow-up data from the European Prospective Investigation of Cancer (EPIC)-Norfolk study of 25,492 participants, for whom CVD and non-CVD mortality was compared.ResultsAt year 5, the observed incidences (with simulated incidences in brackets) of CHD, stroke, and CVD and non-CVD mortality for the 3,478 Rotterdam Study participants were 5.30% (4.68%), 3.60% (3.23%), 4.70% (4.80%), and 7.50% (7.96%), respectively. At year 13, these percentages were 10.60% (10.91%), 9.90% (9.13%), 14.20% (15.12%), and 24.30% (23.42%). After recalibrating the model for the EPIC-Norfolk population, the 10-year observed (simulated) incidences of CVD and non-CVD mortality were 3.70% (4.95%) and 6.50% (6.29%). All observed incidences fell well within the 95% credibility intervals of the simulated incidences.ConclusionsWe have confirmed the internal, predictive, and external validity of the RISC model. These findings provide a basis for analyzing the effects of modifying cardiovascular disease risk factors on the burden of CVD with the RISC model.

【 授权许可】

Unknown   
© van Kempen et al; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.