冠心病发病风险预测模型的系统评价

Systematic review of risk prediction models for coronary heart disease

目的:对冠心病发病风险预测模型进行系统评价,为临床实践提供参考依据。方法:检索PubMed、EMbase、Web of Science、Cochrane Library、中国知网、中国生物医学文献数据库、万方数据库、维普数据库中与冠心病发病风险预测模型有关的研究,检索时限为建库至2022年8月31日。2名研究者独立进行文献筛选和数据提取,并使用风险评估工具分析纳入文献的偏倚性和适用性。结果:纳入冠心病发病风险预测模型的研究共9项。受试者工作特征曲线下面积为0.70~0.86。在所有纳入模型中包含最多的预测因子是年龄、吸烟、糖尿病、血脂异常和血压异常。9项研究总体适用性好,但仍存在样本局限、缺失数据的情况。结论:纳入模型具有较好预测效能,可用于临床早期识别冠心病高风险人群,但模型的外推性未得到有效评价,未来需进一步探究。

Objective:To systematically evaluate the risk prediction models of coronary heart disease and provide a reference for clinical practice.Methods:The research related to the prediction model of coronary heart disease risk was retrieved from PubMed,EMbase,Web of Science,the Cochrane Library,China National Knowledge Infrastructure(CNKI),China BioMedical Literature Database(CBM),WanFang Database,and VIP Database from the establishment of the database to August 31,2022.Two researchers independently performed literature screening and data extraction;risk assessment tools to were used to analyze the bias and applicability of the included literature.Results:A total of 9 studies were included in the risk prediction model of coronary heart disease.The area under the receiver operating characteristic curve ranged from 0.70 to 0.86.The most included predictors in all models were age,smoking,diabetes,dyslipidemia,and abnormal blood pressure.The overall applicability of the 9 studies was good,but there were still sample limitations and missing data.Conclusion:The included model had good predictive efficacy and could be used for early clinical identification of high-risk groups of coronary heart disease.However,the extrapolation of the model has not been effectively evaluated,and further exploration is needed in the future.