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@ARTICLE{Schiborn:172496,
      author       = {C. Schiborn and T. Kühn$^*$ and K. Mühlenbruch and O.
                      Kuxhaus and C. Weikert and A. Fritsche and R. Kaaks$^*$ and
                      M. B. Schulze},
      title        = {{A} newly developed and externally validated non-clinical
                      score accurately predicts 10-year cardiovascular disease
                      risk in the general adult population.},
      journal      = {Scientific reports},
      volume       = {11},
      number       = {1},
      issn         = {2045-2322},
      address      = {[London]},
      publisher    = {Macmillan Publishers Limited, part of Springer Nature},
      reportid     = {DKFZ-2021-02060},
      pages        = {19609},
      year         = {2021},
      abstract     = {Inclusion of clinical parameters limits the application of
                      most cardiovascular disease (CVD) prediction models to
                      clinical settings. We developed and externally validated a
                      non-clinical CVD risk score with a clinical extension and
                      compared the performance to established CVD risk scores. We
                      derived the scores predicting CVD (non-fatal and fatal
                      myocardial infarction and stroke) in the European
                      Prospective Investigation into Cancer and Nutrition
                      (EPIC)-Potsdam cohort (n = 25,992, cases = 683) using
                      competing risk models and externally validated in
                      EPIC-Heidelberg (n = 23,529, cases = 692). Performance was
                      assessed by C-indices, calibration plots, and
                      expected-to-observed ratios and compared to a non-clinical
                      model, the Pooled Cohort Equation, Framingham CVD Risk
                      Scores (FRS), PROCAM scores, and the Systematic Coronary
                      Risk Evaluation (SCORE). Our non-clinical score included
                      age, gender, waist circumference, smoking, hypertension,
                      type 2 diabetes, CVD family history, and dietary parameters.
                      C-indices consistently indicated good discrimination
                      (EPIC-Potsdam 0.786, EPIC-Heidelberg 0.762) comparable to
                      established clinical scores (thereof highest, FRS:
                      EPIC-Potsdam 0.781, EPIC-Heidelberg 0.764). Additional
                      clinical parameters slightly improved discrimination
                      (EPIC-Potsdam 0.796, EPIC-Heidelberg 0.769). Calibration
                      plots indicated very good calibration with minor
                      overestimation in the highest decile of predicted risk. The
                      developed non-clinical 10-year CVD risk score shows
                      comparable discrimination to established clinical scores,
                      allowing assessment of individual CVD risk in
                      physician-independent settings.},
      cin          = {C020},
      ddc          = {600},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34608230},
      doi          = {10.1038/s41598-021-99103-4},
      url          = {https://inrepo02.dkfz.de/record/172496},
}