@article{e7bf006e1ccc4bc5b380a86b8fc077a0,
title = "Novel “predictor patch” method for adding predictors using estimates from outside datasets ― a proof-of-concept study adding kidney measures to cardiovascular mortality prediction ―",
abstract = "Background: Cardiovascular guidelines include risk prediction models for decision making that lack the capacity to include novel predictors. Methods and Results: We explored a new “predictor patch” approach to calibrating the predicted risk from a base model according to 2 components from outside datasets: (1) the difference in observed vs. expected values of novel predictors and (2) the hazard ratios (HRs) for novel predictors, in a scenario of adding kidney measures for cardiovascular mortality. Using 4 US cohorts (n=54,425) we alternately chose 1 as the base dataset and constructed a base prediction model with traditional predictors for cross-validation. In the 3 other “outside” datasets, we developed a linear regression model with traditional predictors for estimating expected values of glomerular filtration rate and albuminuria and obtained their adjusted HRs of cardiovascular mortality, together constituting a “patch” for adding kidney measures to the base model. The base model predicted cardiovascular mortality well in each cohort (c-statistic 0.78-0.91). The addition of kidney measures using a patch significantly improved discrimination (cross-validated ∆c-statistic 0.006 [0.004-0.008]) to a similar degree as refitting these kidney measures in each base dataset. Conclusions: The addition of kidney measures using our new “predictor patch” approach based on estimates from outside datasets improved cardiovascular mortality prediction based on traditional predictors, providing an option to incorporate novel predictors to an existing prediction model.",
keywords = "Cardiovascular disease, Chronic kidney disease, Novel biomarkers, Risk prediction",
author = "Kunihiro Matsushita and Yingying Sang and Jingsha Chen and Ballew, {Shoshana H.} and Michael Shlipak and Josef Coresh and Peralta, {Carmen A.} and Mark Woodward",
note = "Funding Information: K.M. received consultancy and research funding from Kyowa Hakko Kirin outside of the work and consultancy from Akebia and Healthy.io outside of the work. Funding Information: The ARIC study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I. MESA was supported by National Heart, Lung, and Blood Institute contracts N01-HC-95159–N01-HC-95169 and National Center for Research Resource Grants UL1-RR-024156 and UL1-RR-025005. The authors thank the staff and participants of the ARIC study for their important contributions. The authors also thank the other investigators, the staff, and the participants of MESA for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. Funding Information: The ARIC study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I. MESA was supported by National Heart, Lung, and Blood Institute contracts N01-HC-95159-N01-HC-95169 and National Center for Research Resource Grants UL1-RR-024156 and UL1-RR-025005. The authors thank the staff and participants of the ARIC study for their important contributions. The authors also thank the other investigators, the staff, and the participants of MESA for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. Publisher Copyright: {\textcopyright} 2019 Japanese Circulation Society. All rights reserved.",
year = "2019",
doi = "10.1253/circj.CJ-19-0320",
language = "English (US)",
volume = "83",
pages = "1876--1882",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "9",
}