{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:41:18Z","timestamp":1787503278162,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006513","name":"Duke Clinical Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006513","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000769","name":"University of Oxford","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000769","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004323","name":"Amylin Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004323","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To demonstrate the gain in predictive performance when cardiovascular disease (CVD) risk prediction tools (RPTs) incorporate repeated rather than only single measurements of risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We used data from the Exenatide Study of Cardiovascular Event Lowering (EXSCEL) trial to compare the quality of predictions of future major adverse cardiovascular events (MACE) with the Cox proportional hazards model (using single values of risk factors) compared to the Bayesian joint model (using repeated measures of risk factors). The risk of MACE was calculated in patients with type 2 diabetes with and without established CVD. We assessed the predictive ability of the following cardiovascular risk factors: glycated haemoglobin, high\u2010density lipoprotein cholesterol (HDL\u2010C), non\u2010HDL\u2010C, triglycerides, estimated glomerular filtration rate, low\u2010density lipoprotein cholesterol (LDL\u2010C), total cholesterol, and systolic blood pressure (SBP) using the time\u2010dependent area under the receiver\u2010operating characteristic curve (aROC) for discrimination and the time\u2010dependent Brier score for calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In participants without history of CVD, the aROC of SBP increased from 0.62 to 0.69 when repeated rather than only single measurements of SBP were incorporated into the predictive model. Similarly, the aROC increased from 0.67 to 0.80 when repeated rather than only single measurements of both SBP and LDL\u2010C were incorporated into the predictive model. For all other investigated cardiovascular risk factors, the measures of discrimination and calibration both improved when using the joint model as compared to the Cox proportional hazards model. The improvement was evident in participants with and without history of CVD but was more pronounced in the latter group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The analysis demonstrates that the joint modelling approach, considering trajectories of cardiovascular risk factors, provides superior predictive performance compared to standard RPTs that use only a single timepoint.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.14975","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T22:28:38Z","timestamp":1673562518000},"page":"1261-1270","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Joint longitudinal and time\u2010to\u2010event modelling compared with standard Cox modelling in patients with type 2 diabetes with and without established cardiovascular disease: An analysis of the\n                    <scp>EXSCEL<\/scp>\n                    trial"],"prefix":"10.1111","volume":"25","author":[{"given":"Abderrahim","family":"Oulhaj","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Population Health, College of Medicine and Health Sciences Khalifa University  Abu Dhabi United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0109-2969","authenticated-orcid":false,"given":"Faisal","family":"Aziz","sequence":"additional","affiliation":[{"name":"Interdisciplinary Metabolic Medicine Trials Unit, Division of Endocrinology and Diabetology Medical University of Graz  Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abubaker","family":"Suliman","sequence":"additional","affiliation":[{"name":"Institute of Public Health, College of Medicine and Health Sciences UAE University  Al Ain United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayyar","family":"Iqbal","sequence":"additional","affiliation":[{"name":"AstraZeneca Research and Development  Gaithersburg Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5194-8550","authenticated-orcid":false,"given":"Ruth L.","family":"Coleman","sequence":"additional","affiliation":[{"name":"Diabetes Trials Unit, Radcliffe Department of Medicine University of Oxford  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rury R.","family":"Holman","sequence":"additional","affiliation":[{"name":"Diabetes Trials Unit, Radcliffe Department of Medicine University of Oxford  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3510-9594","authenticated-orcid":false,"given":"Harald","family":"Sourij","sequence":"additional","affiliation":[{"name":"Interdisciplinary Metabolic Medicine Trials Unit, 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