@article{pagano_prediction_2021, title = {Prediction of mortality and major cardiovascular complications in type 2 diabetes: External validation of {UK} Prospective Diabetes Study outcomes model version 2 in two European observational cohorts}, volume = {23}, issn = {1463-1326}, url = {https://dom-pubs.onlinelibrary.wiley.com/doi/abs/10.1111/dom.14311}, doi = {10.1111/dom.14311}, shorttitle = {Prediction of mortality and major cardiovascular complications in type 2 diabetes}, abstract = {Aim To externally validate the {UK} Prospective Diabetes Study Outcomes Model version 2 ({UKPDS}-{OM}2) by comparing the predicted and observed outcomes in two European population-based cohorts of people with type 2 diabetes. Materials and methods We used data from the Casale Monferrato Survey ({CMS}; n = 1931) and a subgroup of the Hoorn Diabetes Care System ({DCS}) cohort (n = 5188). The following outcomes were analysed: all-cause mortality, myocardial infarction ({MI}), ischaemic heart disease ({IHD}), stroke, and congestive heart failure ({CHF}). Model performance was assessed by comparing predictions with observed cumulative incidences in each cohort during follow-up. Results All-cause mortality was overestimated by the {UKPDS}-{OM}2 in both the cohorts, with a bias of 0.05 in the {CMS} and 0.12 in the {DCS} at 10 years of follow-up. For {MI}, predictions were consistently higher than observed incidence over the entire follow-up in both cohorts (10 years bias 0.07 for {CMS} and 0.10 for {DCS}). The model performed well for stroke and {IHD} outcomes in both cohorts. {CHF} incidence was predicted well for the {DCS} (5 years bias −0.001), but underestimated for the {CMS} cohort. Conclusions The {UKPDS}-{OM}2 consistently overpredicted the risk of mortality and {MI} in both cohorts during follow-up. Period effects may partially explain the differences. Results indicate that transferability is not satisfactory for all outcomes, and new or adjusted risk equations may be needed before applying the model to the Italian or Dutch settings.}, pages = {1084--1091}, journaltitle = {Diabetes, Obesity and Metabolism}, author = {Pagano, Eva and Konings, Stefan R. A. and Cuonzo, Daniela Di and Rosato, Rosalba and Bruno, Graziella and Heijden, Amber A. van der and Beulens, Joline and Slieker, Roderick and Leal, Jose and Feenstra, Talitha L.}, urldate = {2021-02-04}, date = {2021}, langid = {english}, note = {\_eprint: https://dom-pubs.onlinelibrary.wiley.com/doi/pdf/10.1111/dom.14311}, keywords = {{WP}8, cardiovascular disease, diabetes complications, health economics}, }