{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:40:00Z","timestamp":1790959200503,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:00:00Z","timestamp":1706659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To validate cardiovascular risk prediction models for individuals with diabetes using the UK Biobank in order to assess their applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We externally validated 19 cardiovascular risk scores from seven risk prediction models (Chang et al., Framingham, University of Hong Kong\u2010Singapore [HKU\u2010SG], Li et al, RECODe [risk equations for complications of type 2 diabetes], SCORE [Systematic Coronary Risk Evaluation] and the UK Prospective Diabetes Study Outcomes Model 2 [UKPDS OM2]), identified from systematic reviews, using UK Biobank data from 2006 to 2021 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923\u2009685; participant age 40\u201371\u2009years, 63.5% male). We evaluated performance by assessing the discrimination and calibration of the models for the endpoints of mortality, cardiovascular mortality, congestive heart failure, myocardial infarction, stroke, and ischaemic heart disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a total of 269\u2009430 person\u2010years of follow\u2010up (median 11.89\u2009years), the models showed low\u2010to\u2010moderate discrimination performance on external validation (concordance indices [c\u2010indices] 0.50\u20130.71). Most models had low calibration with overprediction of the observed risk. RECODe outperformed other models across four comparable endpoints for discrimination: all\u2010cause mortality (c\u2010index\u20090.67, 95% confidence interval [CI] 0.65\u20130.69), congestive heart failure (c\u2010index\u20090.71, 95% CI 0.69\u20130.72), myocardial infarction (c\u2010index\u20090.67, 95% CI 0.65\u20130.68); and stroke (c\u2010index\u20090.65, 95% CI 0.62\u20130.68), and for calibration (except for all\u2010cause mortality). The UKPDS OM2 had comparable performance to RECODe for all\u2010cause mortality (c\u2010index\u20090.67, 95% CI 0.66\u20130.69) and cardiovascular mortality (c\u2010index\u20090.71, 95% CI 0.70\u20130.73), but worse performance for other outcomes. The models performed better for younger participants and somewhat better for non\u2010White ethnicities. Models developed from non\u2010Western datasets showed worse performance in our UK\u2010based validation set.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The RECODe model led to better risk estimations in this predominantly White European population. Further validation is needed in non\u2010Western populations to assess generalizability to other populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15474","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T02:01:31Z","timestamp":1706752891000},"page":"1697-1705","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of prediction models for cardiovascular and mortality risk in people with type 2 diabetes: An external validation in 23\u2009685 adults included in the\n                    <scp>UK<\/scp>\n                    Biobank"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3104-646X","authenticated-orcid":false,"given":"Yikun","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0432-5027","authenticated-orcid":false,"given":"Ong Xin","family":"Jiong","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqi","family":"Tang","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yui Chit","family":"Tang","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheuk Tung","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4219-3907","authenticated-orcid":false,"given":"Carmen S.","family":"Ng","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8386-8512","authenticated-orcid":false,"given":"Jianchao","family":"Quan","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine The University of Hong Kong  Hong Kong SAR China"},{"name":"HKU Business School The University of Hong Kong  Hong Kong SAR China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,31]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2021"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933\u2010022\u201001516\u20106"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl\u20102021\u2010319243"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109089"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2416"},{"key":"e_1_2_10_7_1","volume-title":"Enable your Research","author":"UK Biobank","year":"2023"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(17)30221\u20108"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201012751\u20103"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.6084\/m9.figshare.9888923.v2"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0195\u2010668X(03)00114\u20103"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010013\u20102940\u2010y"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.159.11.1197"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.25.1.40"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.01.034"},{"key":"e_1_2_10_16_1","unstructured":"Dr Ehsan Vaghefi.Approved Research\u2010Predicting Cardiovascular risk from retinal photographs and limited demographic data: An external validation of a New Zealand algorithm. n.d.https:\/\/www.ukbiobank.ac.uk\/enable\u2010your\u2010research\/approved\u2010research\/predicting\u2010cardiovascular\u2010risk\u2010from\u2010retinal\u2010photographs\u2010and\u2010limited\u2010demographic\u2010data\u2010an\u2010external\u2010validation\u2010of\u2010a\u2010new\u2010zealand\u2010algorithm(Accessed May 30 2023)"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102017\u2010315730"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2017.463"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15598"},{"key":"e_1_2_10_20_1","unstructured":"KhanA.ICD10 and ICD9 Codes Conversion.2023."},{"key":"e_1_2_10_21_1","unstructured":"2018 ICD\u201010 CM and GEMs | CMSn.d.https:\/\/www.cms.gov\/Medicare\/Coding\/ICD10\/2018\u2010ICD\u201010\u2010CM\u2010and\u2010GEMs(Accessed May 24 2023)."},{"key":"e_1_2_10_22_1","unstructured":"World Health Organization. ICD\u201010 Version: 2019n.d.https:\/\/icd.who.int\/browse10\/2019\/en#\/(accessed March 22 2023)."},{"key":"e_1_2_10_23_1","unstructured":"Radcliffe Department of Medicine. UKPDS Outcomes Model V2 (OM2)n.d.https:\/\/www.rdm.ox.ac.uk\/about\/our-clinical-facilities-and-mrc-units\/DTU\/software\/outcomes(Accessed October 31 2023)."},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17\u20102002"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwx246"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.2337\/cd23\u2010as01"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.15474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T04:51:09Z","timestamp":1761886269000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.15474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,31]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1111\/dom.15474"],"URL":"https:\/\/doi.org\/10.1111\/dom.15474","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.15474\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15474\/v3\/review1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,31]]},"assertion":[{"value":"2023-08-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}