This high-performing CVD risk model allows for the implementation of decision rules in a clinical setting.Ĭardiovascular diseases diabetes mellitus, type 1 models, cardiovascular risk factors survival analysis. The Hosmer-Lemeshow test showed good calibration (P>0.05) in both cohorts. Discrimination was excellent for a 5-year CVD event with a C-statistic of 0.826 (95% confidence interval, 0.807-0.845) in the derivation data and a C-statistic of 0.803 (95% confidence interval, 0.767-0.839) in the validation data. Current in-app purchases are 99 cents to 99.99 for both Android and iPhone devices. However, the game comes with in-app purchases for different packs, diamonds, and gifts. Players can download and play without spending money. The final prediction model included age, sex, diabetes duration, systolic blood pressure, low-density lipoprotein cholesterol, hemoglobin A1c, albuminuria, glomerular filtration rate, smoking, and exercise. The Rules of Survival is a free-to-play app. During a median follow-up of 6.8 years (interquartile range, 2.9-10.9) a total of 793 (18.4%) patients developed CVD. The final CVD prediction model was externally validated in a different population of 2119 patients with type 1 diabetes mellitus. Second, based on results from the first step, Poisson regression analysis was used to derive the final model. First, a nonparametric, data-driven approach was used to identify potentially informative risk factors and interactions (random forest and survival tree analysis). The risk prediction model was developed by using a 2-stage approach. Detailed clinical data including lifestyle factors were linked to event data from validated national registers. There are no risk scores used on a regular basis in clinical practice for assessing the risk of CVD in type 1 diabetes mellitus.įrom 4306 clinically diagnosed adult patients with type 1 diabetes mellitus, we developed a prediction model for estimating the risk of first fatal or nonfatal CVD event (ischemic heart disease, ischemic stroke, heart failure, and peripheral artery disease). Patients with type 1 diabetes mellitus are at increased risk of developing cardiovascular disease (CVD), but they are currently undertreated.
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