Abstract 14620: Validation of the Non-laboratory Based Framingham Algorithm in the Atherosclerosis Risk in Communities Dataset
Background: In recent years, non-Laboratory based (non-LB) risk assessment algorithms have been developed to facilitate absolute cardiovascular disease (CVD) risk assessment in resource constrained settings. The non-LB Framingham algorithm, which substitutes body mass index (BMI) for lipids, has the best discrimination and calibration among published algorithms but its external validity has not been determined. This study aims to validate the non-LB Framingham algorithm in a racially diverse sample.
Methods: Secondary data analysis using Atherosclerosis Risk in Communities (ARIC) dataset. Cox regression models including the non-LB and Lab-based (LB) Framingham covariates were developed. Models discrimination assessed via C-statistic, calibration via goodness-of-fit test, and equivalence of regression coefficients via z-test. Algorithms based on the models evaluated using area under receiver operating characteristic (AUROC) curve. IRB approval obtained. Data analyzed using Stata© software version 14.
Results: Among 11601 individuals (mean age 53.9 ± 5.7 years, 55% female, 24% black) the non-LB vs LB models performed as follows: C-statistic (0.75 vs 0.76 for women & 0.67 vs 0.68 for men); goodness-of-fit (14.2 vs 10.5 for women & 25.8 vs 21.8 for men) respectively. In the black sample, all regression coefficients correlated those in Framingham (z = ±1.96). Overall, the non-LB vs LB Framingham algorithms had AUROC of 0.706 vs 0.710 respectively.
Conclusions: These results demonstrate the validity of the non-LB Framingham algorithm. This approach could provide a valuable and efficient alternative to the traditional LB approaches in the ongoing efforts to address the high burden of CVD in underserved communities especially the US black population.
Author Disclosures: J.K. Kariuki: None. E.M. Stuart-Shor: None. S.G. Leveille: None. P. Gona: None. J. Cromwell: None.
- © 2016 by American Heart Association, Inc.