Calibration between the Estimated Probability of the Risk Assessment Chart of Japan Atherosclerosis Society and Actual Mortality Using External Population: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN)

Michikazu Nakai; Yoshihiro Miyamoto; Aya Higashiyama; Yoshitaka Murakami; Kunihiro Nishimura; Hiroshi Yatsuya; Shigeyuki Saitoh; Kiyomi Sakata; Hiroyasu Iso; Katsuyuki Miura; Hirotsugu Ueshima; Tomonori Okamura; The EPOCH-JAPAN Research Group

doi:10.5551/jat.31286

Original Article

Calibration between the Estimated Probability of the Risk Assessment Chart of Japan Atherosclerosis Society and Actual Mortality Using External Population: Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN)

Michikazu Nakai, Yoshihiro Miyamoto, Aya Higashiyama, Yoshitaka Murakami, Kunihiro Nishimura, Hiroshi Yatsuya, Shigeyuki Saitoh, Kiyomi Sakata, Hiroyasu Iso, Katsuyuki Miura, Hirotsugu Ueshima, Tomonori Okamura, The EPOCH-JAPAN Research Group

Author information

Michikazu Nakai
Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
Yoshihiro Miyamoto
Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center
Department of Preventive Cardiology, National Cerebral and Cardiovascular Center
Aya Higashiyama
Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center
Yoshitaka Murakami
Department of Medical Statistics, Toho University
Kunihiro Nishimura
Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center
Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center
Hiroshi Yatsuya
Department of Public Health, Fujita Health University School of Medicine
Shigeyuki Saitoh
Nursing subject, Sapporo Medical University School of Health Sciences
Kiyomi Sakata
Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine
Hiroyasu Iso
Public Health Graduate School of Medicine, Osaka University
Katsuyuki Miura
Department of Public Health, Shiga University of Medical Science
Center for Epidemiologic Research in Asia
Hirotsugu Ueshima
Center for Epidemiologic Research in Asia
Tomonori Okamura
Department of Preventive Medicine and Public Health, Keio University School of Medicine
The EPOCH-JAPAN Research Group

Keywords: External calibration, Cohort studies, Pooled analysis, Risk assessment Chart, Stroke, Coronary artery disease

JOURNAL OPEN ACCESS

2016 Volume 23 Issue 2 Pages 176-195

DOI https://doi.org/10.5551/jat.31286

Browse “Advance online publication” version

Details

Abstract

Aim: In Japan Atherosclerosis Society guidelines for the prevention of atherosclerotic cardiovascular diseases 2012 (JAS2012), NIPPON DATA80 risk assessment chart (ND80RAC) was adopted to estimate the 10-year probability of coronary artery disease (CAD) mortality. However, there was no comparison between the estimated mortality calculated by ND80RAC and actual mortality in external populations. Accordingly, we used the large pooled database of cohorts in Japan, EPOCH-JAPAN, as an external population.
Methods: The participants of EPOCH-JAPAN without a history of cardiovascular disease (15,091 men and 18,589 women aged 40–74 years) were analyzed based on sex. The probability of a 10-year risk of CAD/stroke mortality was estimated by ND80RAC. The participants were divided into both decile of their estimated mortality and three categories according to JAS2012. The calibration between the mean estimated mortality and the actual mortality was performed by the Hosmer and Lemeshow (H-L) test.
Results: In both sexes, the estimated CAD mortality was higher than the actual mortality, particularly in higher deciles of estimated mortality, and the estimated stroke mortality was almost concordant with the actual mortality in low/moderate deciles of estimated mortality. As for the categories according to JAS2012, the estimated CAD mortality was higher than the actual mortality in both sexes; actual mortality in Category III was lower than that in Category II in women. However, it increased in the ascending order of category when we excluded the presence of diabetes from Category III.
Conclusions: The estimated CAD mortality by ND80RAC tended to be higher than the actual mortality in the population in which the baseline survey was more recently performed.

Corresponding author

Register with J-STAGE for free!