Читать книгу Diabetic Retinopathy and Cardiovascular Disease - Группа авторов - Страница 19

As early as the late 1970s, the first widely used cardiovascular risk score was developed, which is the Framingham Risk Score [30]. Over recent decades, more than 45 additional scores applicable to patients with diabetes have been published [31]. Some have been developed in populations with diabetes and others in general populations but include diabetes status as a variable. Most cardiovascular risk scores that have been assessed in diabetes populations include similar parameters such as age, sex, smoking status, systolic blood pressure, lipids and, for those scores that are not diabetes-specific, diabetes status. Some scores include additional factors such as HbA1c; weight or body mass index; chronic kidney disease stage, estimated glomerular filtration rate (eGFR), or presence of albuminuria; presence of retinopathy; ethnicity; family history; and markers of social deprivation. Risk scores are now being incorporated into diabetes guidelines and increasingly used in clinical practice, mostly being available as charts or as web-based calculators. The statistical models underlying these scores use a patient’s personal risk factor values and the average cardiovascular disease risk of the population to predict the individual’s risk of a cardiovascular event within a specified time frame, often 10-years. Establishing a clinical risk score should involve 3 key stages [31]:

1. development and internal validation

2. external validation

3. model impact studies