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Lab-based = non-lab-based models for CVD prediction


Clinical Question:
Are risk prediction methods using laboratory testing and methods not using laboratory testing comparable in predicting cardiovascular events?

Bottom Line:
Cardiovascular prediction models that do not require laboratory testing perform as well as models that use laboratory testing. (LOE = 2b)

Gaziano TA, Young CR, Fitzmaurice G, Atwood S, Gaziano JM. Laboratory-based versus non-laboratory-based method for assessment of cardiovascular disease risk: the NHANES I Follow-up Study cohort. Lancet 2008;371(9616):923-931.  [PMID:18342687]

Study Design:
Cohort (prospective)


Since most of the world's cardiovascular deaths occur in developing countries where laboratory testing is a costly luxury, these researchers sought to determine if cardiovascular prediction models that don't use laboratory testing perform as well as those that do. To do this, they identified nearly 6200 patients with no known heart disease and used Framingham-based prediction models to estimate cardiovascular disease risk. In the Framingham model, cholesterol levels are used along with other factors. These researchers replaced body mass index for cholesterol in the nonlaboratory-based model. The patients had completed a comprehensive set of surveys and tests in the 1970s and their vital status was assessed 20 years later. The research team obtained medical records, pathology reports, electrocardiograms, and so forth to confirm diagnoses. Finally, they evaluated the performance of the models on men and on women. During the 21 years of follow up, 38% of the patients died from cardiovascular disease and there were more than 1500 first-time cardiovascular events. For women, both prediction models were 83% accurate. For men, both models were 78% accurate.

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Slawson, David C., et al., editors. "Lab-based = Non-lab-based Models for CVD Prediction." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426151/all/Lab_based_=_non_lab_based_models_for_CVD_prediction.
Lab-based = non-lab-based models for CVD prediction. In: Slawson DC, Shaughnessy AF, Ebell MH, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426151/all/Lab_based_=_non_lab_based_models_for_CVD_prediction. Accessed May 21, 2019.
Lab-based = non-lab-based models for CVD prediction. (2019). In Slawson, D. C., Shaughnessy, A. F., Ebell, M. H., & Barry, H. (Eds.), EE+ POEM Archive. Available from https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426151/all/Lab_based_=_non_lab_based_models_for_CVD_prediction
Lab-based = Non-lab-based Models for CVD Prediction [Internet]. In: Slawson DC, Shaughnessy AF, Ebell MH, Barry H, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2019 May 21]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426151/all/Lab_based_=_non_lab_based_models_for_CVD_prediction.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Lab-based = non-lab-based models for CVD prediction ID - 426151 ED - Slawson,David C, ED - Shaughnessy,Allen F, ED - Ebell,Mark H, ED - Barry,Henry, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426151/all/Lab_based_=_non_lab_based_models_for_CVD_prediction PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -