Optimal risk-assessment scheduling for primary prevention of cardiovascular disease
In this work, we introduce a personalized and age-specific net benefit function, composed of benefits and costs, to recommend optimal timing of risk assessments for cardiovascular disease (CVD) prevention. We extend the 2-stage landmarking model to estimate patient-specific CVD risk profiles, adjusting for time-varying covariates. We apply our model to data from the Clinical Practice Research Datalink, comprising primary care electronic health records from the UK. We find that people at lower risk could be recommended an optimal risk-assessment interval of 5 years or more. Time-varying risk factors are required to discriminate between more frequent schedules for high-risk people.
Authors
- Francesca Gasperoni (ORCID: https://orcid.org/0000-0002-1713-9477)
- Angela Wood (ORCID: https://orcid.org/0000-0002-7937-304X)
- David A. Stevens (ORCID: https://orcid.org/0000-0002-5861-5716)
- Christopher Jackson (ORCID: https://orcid.org/0000-0002-6656-8913)
- Michael Sweeting (ORCID: https://orcid.org/0000-0003-0980-8965)
- Paul J. Newcombe (ORCID: https://orcid.org/0000-0002-5611-6702)
- Jessica Barrett (ORCID: https://orcid.org/0000-0003-1889-9803)
Institutions
- University of Liverpool (GB)
- University of Leicester (GB)
- University of Cambridge (GB)
- Liverpool Heart and Chest Hospital (GB)
- MRC Biostatistics Unit (GB)
- Health Data Research UK (GB)
- Department of Public Health (US)
Publication Details
- Journal
- Journal of the Royal Statistical Society Series A (Statistics in Society)
- Published
- 2024-09-17
- DOI
- https://doi.org/10.1093/jrsssa/qnae086
- Citations
- 4
- Primary Topic
- Health Systems, Economic Evaluations, Quality of Life
- Type
- article
- Field-Weighted Citation Impact
- 4.52
Funders
- National Institute on Handicapped Research
- Scottish Government
- National Institute for Health and Care Research
- British Heart Foundation
- Department of Health and Social Care
- Public Health Agency
- Chief Scientist Office, Scottish Government Health and Social Care Directorate
- Medical Research Council
- Engineering and Physical Sciences Research Council
- Economic and Social Research Council
- Health and Social Care Research and Development Division
- NIHR Cambridge Biomedical Research Centre