A new risk equation method for complications of type 2 diabetes derived from the ACCORD trial worked better than 2 commonly used alternatives in a study involving >3,300 individuals. Investigators compared the 3 methods--including the one taken from ACCORD (called RECODe), an ACC/AHA model, and 1 from the UK Prospective Diabetes Study Outcomes Model 2--with outcomes in the MESA and Jackson Heart studies. Among the results:
- RECODe equations for microvascular and cardiovascular outcomes had C-statistics for discrimination ranging from 0.71 to 0.85 in MESA and 0.64 to 0.91 in Jackson Heart for alternative outcomes.
- Calibration slopes in MESA ranged from 0.62 for a composite nephropathy outcome, 0.83 to 1.04 for individual nephropathy outcomes, 1.07 for retinopathy, 1.00 to 1.05 for cardiovascular outcomes, and 1.03 for all-cause mortality.
- Slopes in Jackson Heart ranged from 0.47 for retinopathy, 0.97 to 1.16 for nephropathy, 0.72 to 1.05 for cardiovascular outcomes, and 1.01 for all-cause mortality.
- The alternative models had C-statistics 0.50 to 0.72 and calibration slopes 0.07 to 0.60.
Basu S, Sussman J, Berkowitz S, et al. Validation of risk equations for complications of type 2 diabetes (RECODe) using individual participant data from diverse longitudinal cohorts in the US. [Published online ahead of print December 19, 2017]. Diabetes Care. doi:10.2337/dc17-2002.