@article{21404,
  keywords = {Female, Humans, Male, Middle Aged, Cohort Studies, Age Factors, Body Mass Index, Diabetes Mellitus, Type 2/ epidemiology, European Continental Ancestry Group, Models, Biological, Risk Assessment/methods, Sex Factors, Waist Circumference},
  author = {van der Schouw Y. and Kengne A. and Franks P. and Peelen L. and Moons K. and Li K. and Grobbee D. and Beulens J. and Schulze M. and Spijkerman A. and Griffin S. and Palla L. and Tormo M. and Arriola L. and Barengo N. and Barricarte A. and Boeing H. and Bonet C. and Clavel-Chapelon F. and Dartois L. and Fagherazzi G. and Huerta J. and Kaaks R. and Key T. and Khaw K. and Muhlenbruch K. and Nilsson P. and Overvad K. and Overvad T. and Palli D. and Panico S. and Quiros J. and Rolandsson O. and Roswall N. and Sacerdote C. and Sanchez M. and Slimani N. and Tagliabue G. and Tjonneland A. and Tumino R. and A. van der Dl and Forouhi N. and Sharp S. and Langenberg C. and Riboli E. and Wareham N.},
  title = {Non-invasive risk scores for prediction of type 2 diabetes (EPIC-InterAct): a validation of existing models},
  abstract = {<p>
BACKGROUND: The comparative performance of existing models for prediction of type 2 diabetes across populations has not been investigated. We validated existing non-laboratory-based models and assessed variability in predictive performance in European populations. METHODS: We selected non-invasive prediction models for incident diabetes developed in populations of European ancestry and validated them using data from the EPIC-InterAct case-cohort sample (27,779 individuals from eight European countries, of whom 12,403 had incident diabetes). We assessed model discrimination and calibration for the first 10 years of follow-up. The models were first adjusted to the country-specific diabetes incidence. We did the main analyses for each country and for subgroups defined by sex, age (&lt;60 years vs &gt;/=60 years), BMI (&lt;25 kg/m(2)vs &gt;/=25 kg/m(2)), and waist circumference (men &lt;102 cm vs &gt;/=102 cm; women &lt;88 cm vs &gt;/=88 cm). FINDINGS: We validated 12 prediction models. Discrimination was acceptable to good: C statistics ranged from 0.76 (95% CI 0.72-0.80) to 0.81 (0.77-0.84) overall, from 0.73 (0.70-0.76) to 0.79 (0.74-0.83) in men, and from 0.78 (0.74-0.82) to 0.81 (0.80-0.82) in women. We noted significant heterogeneity in discrimination (pheterogeneity&lt;0.0001) in all but one model. Calibration was good for most models, and consistent across countries (pheterogeneity&gt;0.05) except for three models. However, two models overestimated risk, DPoRT by 34% (95% CI 29-39%) and Cambridge by 40% (28-52%). Discrimination was always better in individuals younger than 60 years or with a low waist circumference than in those aged at least 60 years or with a large waist circumference. Patterns were inconsistent for BMI. All models overestimated risks for individuals with a BMI of &lt;25 kg/m(2). Calibration patterns were inconsistent for age and waist-circumference subgroups. INTERPRETATION: Existing diabetes prediction models can be used to identify individuals at high risk of type 2 diabetes in the general population. However, the performance of each model varies with country, age, sex, and adiposity. FUNDING: The European Union.
</p>
},
  year = {2014},
  journal = {The lancet. Diabetes & Endocrinology},
  volume = {2},
  edition = {2014/03/14},
  number = {1},
  pages = {19-29},
  isbn = {2213-8595 (Electronic)},
  note = {Kengne, Andre Pascal<br/>Beulens, Joline W J<br/>Peelen, Linda M<br/>Moons, Karel G M<br/>van der Schouw, Yvonne T<br/>Schulze, Matthias B<br/>Spijkerman, Annemieke M W<br/>Griffin, Simon J<br/>Grobbee, Diederick E<br/>Palla, Luigi<br/>Tormo, Maria-Jose<br/>Arriola, Larraitz<br/>Barengo, Noel C<br/>Barricarte, Aurelio<br/>Boeing, Heiner<br/>Bonet, Catalina<br/>Clavel-Chapelon, Francoise<br/>Dartois, Laureen<br/>Fagherazzi, Guy<br/>Franks, Paul W<br/>Huerta, Jose Maria<br/>Kaaks, Rudolf<br/>Key, Timothy J<br/>Khaw, Kay Tee<br/>Li, Kuanrong<br/>Muhlenbruch, Kristin<br/>Nilsson, Peter M<br/>Overvad, Kim<br/>Overvad, Thure F<br/>Palli, Domenico<br/>Panico, Salvatore<br/>Quiros, J Ramon<br/>Rolandsson, Olov<br/>Roswall, Nina<br/>Sacerdote, Carlotta<br/>Sanchez, Maria-Jose<br/>Slimani, Nadia<br/>Tagliabue, Giovanna<br/>Tjonneland, Anne<br/>Tumino, Rosario<br/>van der A, Daphne L<br/>Forouhi, Nita G<br/>Sharp, Stephen J<br/>Langenberg, Claudia<br/>Riboli, Elio<br/>Wareham, Nicholas J<br/>16491/Cancer Research UK/United Kingdom<br/>G1000143/Medical Research Council/United Kingdom<br/>MC_U106179471/Medical Research Council/United Kingdom<br/>MC_U106179474/Medical Research Council/United Kingdom<br/>MC_UP_A100_1003/Medical Research Council/United Kingdom<br/>MC_UU_12015/1/Medical Research Council/United Kingdom<br/>MC_UU_12015/4/Medical Research Council/United Kingdom<br/>MC_UU_12015/5/Medical Research Council/United Kingdom<br/>NF-SI-0512-10114/Department of Health/United Kingdom<br/>NF-SI-0512-10135/Department of Health/United Kingdom<br/>Cancer Research UK/United Kingdom<br/>Medical Research Council/United Kingdom<br/>Research Support, Non-U.S. Gov't<br/>Validation Studies<br/>England<br/>Lancet Diabetes Endocrinol. 2014 Jan;2(1):19-29. doi: 10.1016/S2213-8587(13)70103-7. Epub 2013 Oct 8.},
  language = {eng},
}