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Recalibration of the Framingham Equations in the Thai Population

Recalibration of the Framingham Equations in the Thai Population. Panrasri Khonputsa et al. Objectives. To develop Thailand specific equations derived from the Framingham cohort data,

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Recalibration of the Framingham Equations in the Thai Population

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  1. Recalibration of the Framingham Equations in the Thai Population Panrasri Khonputsa et al.

  2. Objectives • To develop Thailand specific equations derived from the Framingham cohort data, • To calibrate these to the best available information on the incidence and cumulative risks of CVD in Thailand

  3. Materials and methods • Cardiovascular disease (CVD) incidence and cumulative risks • Recalibration of the Framingham equations • Validation against Asia Pacific Cohort Studies Collaboration (APCSC) equation, Electricity Generating Authority of Thailand (EGAT) cohort

  4. Procedures used to assess the incidence of ischemic heart disease and stroke in Thailand

  5. Framingham equations

  6. Recalibration • Applying the ratio • Example • average 10-year Framingham-predicted risk of IHD for Thai men aged 30-35 years = 5% • 10-year cumulative IHD risk for this age and sex = 2.5% • calibration ratio = 0.5 • a Thai man aged 32 years with 10-year Framingham-predicted IHD risk of 6% would have a recalibrated 10-year IHD risk of 3% (6 x 0.5)

  7. Results • Before and after calibration ten-year CVD risk • APCSC and this study’s equation Comparison of the 8-year cardiovascular risks • Predicted vs. observed number of cardiovascular disease events in the EGAT cohort.

  8. Ten-year CVD risk before and after calibration (men , women)

  9. 8-year risks predicted using APCSC vs. this study’s equations

  10. Predicted vs. observed number of CVD in EGAT cohort

  11. Conclusion • Tools performed as well as an existing equation • Can predict number of CVD events over 10 years reasonably well • Flexible; over any time period, and in women and men • Can be used by physicians to inform patients - their risks and options for risk reduction. • Used in cost-effectiveness studies

  12. Limitations • Incidence of non-fatal IHD and stroke may be underestimated (only admitted cases) • Universal access to health services facilitates most cases of IHD and stroke to present to hospital • First-ever proportions from elsewhere

  13. Recommendations • Update incidence and cumulative risks by updating the Thai data sources (DRG, Cause of Death study) • Consider conducting a cohort study representing the whole population to estimate the incidence and risk of CVD • Re-validate the equations by applying the equations in a group of Thais with known risk factor levels and following them for comparison of predicted and observed risks

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