{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:52:32Z","timestamp":1787961152734,"version":"build-2784847793"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Because of a low prevalence of severe carotid stenosis in the general population, screening for presence of asymptomatic carotid artery stenosis (ACAS) is not warranted. Possibly, for certain subgroups, screening is worthwhile. The present study aims to develop prediction rules for the presence of ACAS (&gt;50% and &gt;70%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Individual participant data from 4 population-based cohort studies (Malm\u00f6 Diet and Cancer Study, Troms\u00f8 Study, Carotid Atherosclerosis Progression Study, and Cardiovascular Health Study; totaling 23 706 participants) were pooled. Multivariable logistic regression was performed to determine which variables predict presence of ACAS (&gt;50% and &gt;70%). Calibration and discrimination of the models were assessed, and bootstrapping was used to correct for overfitting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Age, sex, history of vascular disease, systolic and diastolic blood pressure, total cholesterol\/high-density lipoprotein ratio, diabetes mellitus, and current smoking were predictors of stenosis (&gt;50% and &gt;70%). The calibration of the model was good confirmed by a nonsignificant Hosmer and Lemeshow test for moderate (\n              <jats:italic>P<\/jats:italic>\n              =0.59) and severe stenosis (\n              <jats:italic>P<\/jats:italic>\n              =0.07). The models discriminated well between participants with and without stenosis, with an area under the receiver operating characteristic curve corrected for over optimism of 0.82 (95% confidence interval, 0.80\u20130.84) for moderate stenosis and of 0.87 (95% confidence interval, 0.85\u20130.90) for severe stenosis. The regression coefficients of the predictors were converted into a score chart to facilitate practical application.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>A clinical prediction rule was developed that allows identification of subgroups with high prevalence of moderate (&gt;50%) and severe (&gt;70%) ACAS. When confirmed in comparable cohorts, application of the prediction rule may lead to a reduction in the number needed to screen for ACAS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.114.005145","type":"journal-article","created":{"date-parts":[[2014,7,4]],"date-time":"2014-07-04T06:17:49Z","timestamp":1404454669000},"page":"2366-2371","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":93,"title":["Prediction of Asymptomatic Carotid Artery Stenosis in the General Population"],"prefix":"10.1161","volume":"45","author":[{"given":"Marjolein","family":"de Weerd","sequence":"first","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacoba P.","family":"Greving","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Hedblad","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias W.","family":"Lorenz","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellisiv B.","family":"Mathiesen","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel H.","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Rosvall","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Sitzer","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert Jan","family":"de Borst","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Buskens","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel L.","family":"Bots","sequence":"additional","affiliation":[{"name":"From the Julius Center for Health Sciences and Primary Care (M.d.W., J.P.G., M.L.B.) and Department of Vascular Surgery (G.J.d.B.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Clinical Sciences, Cardiovascular Epidemiology (B.H.) and Department of Clinical Sciences, Social Epidemiology (M.R.), Lund University, Malm\u00f6 University Hospital, Malm\u00f6, Sweden; Department of Neurology, Johann Wolfgang Goethe University, Frankfurt am Main, Germany (M.W.L., M.S.); Department of..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.hjr.0000277988.18096.3b"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192667"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67702-1"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000170368.82460.b4"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2012.04.015"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/110.3.777"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006083422302"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.22.12.1485"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(87)90238-8"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.59.7.1162"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs092"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182051b4c"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.111.669267"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2007.00096.x"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1159\/000047680"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.atv.0000032006.75577.24"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2000.00280.x"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000196964.24024.ea"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.23.12.1752"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.01.014"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b604"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b605"},{"issue":"2","key":"e_1_3_4_25_2","first-page":"S1","article-title":"2013 ACC\/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines.","volume":"129","author":"Stone NJ","year":"2014","unstructured":"Stone NJ, Robinson J, Lichtenstein AH, Bairy Merz CN, Blum CB, Eckel RH, et al.. 2013 ACC\/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines. 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