Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review
- Autores
- Carrillo Larco, Rodrigo M.; Altez Fernandez, Carlos; Pacheco Barrios, Niels; Bambs, Claudia; Irazola, Vilma; Miranda, J. Jaime; Miranda, J. Jaime; Danaei, Goodarz; Perel, Pablo Roberto
- Año de publicación
- 2019
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- Background: Cardiovascular prognostic models guide treatment allocation and support clinical decisions. Whether there are valid models for Latin American and Caribbean (LAC) populations is unknown. Objective: This study sought to identify and critically appraise cardiovascular prognostic models developed, tested, or recalibrated in LAC populations. Methods: The systematic review followed the CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies) framework (PROSPERO [International Prospective Register of Systemic Reviews]: CRD42018096553). Reports were included if they followed a prospective design and presented a multivariable prognostic model; reports were excluded if they studied symptomatic individuals or patients. The following search engines were used: EMBASE, MEDLINE, Scopus, SciELO, and LILACS. Risk of bias assessment was conducted with PROBAST (Prediction model Risk Of Bias ASsessment Tool). No quantitative summary was conducted due to large heterogeneity. Results: From 2,506 search results, 8 studies (N = 130,482 participants) were included for qualitative synthesis. We could not identify any cardiovascular prognostic model developed for LAC populations; reviewed reports evaluated available models or conducted a recalibration analysis. Only 1 study included a Caribbean population (Puerto Rico); 3 studies were retrieved from Chile; 2 from Argentina, Brazil, Colombia, and Uruguay; and 1 from Mexico. Four studies included population-based samples, and the other 4 included people affiliated to a health facility (e.g., prevention clinics). Most studied participants were older than 50 years, and there were more women in 5 reports. The Framingham model was assessed 6 times, and the American College of Cardiology/American Heart Association pooled equation was assessed twice. Across the prognostic models assessed, calibration varied widely from one population to another, showing great overestimation particularly in some subgroups (e.g., highest risk). Discrimination (e.g., C-statistic) was acceptable for most models; for Framingham it ranged from 0.66 to 0.76. The American College of Cardiology/American Heart Association pooled equation showed the best discrimination (0.78). That there were few outcome events was the most important methodological limitation of the identified studies. Conclusions: No cardiovascular prognostic models have been developed in LAC, hampering key evidence to inform public health and clinical practice. Validation studies need to improve methodological issues.
Fil: Carrillo Larco, Rodrigo M.. Imperial College London; Reino Unido
Fil: Altez Fernandez, Carlos. Universidad Peruana Cayetano Heredia; Perú
Fil: Pacheco Barrios, Niels. Universidad Peruana Cayetano Heredia; Perú
Fil: Bambs, Claudia. Pontificia Universidad Católica de Chile; Chile
Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; Perú
Fil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; Perú
Fil: Danaei, Goodarz. Harvard University. Harvard School of Public Health; Estados Unidos
Fil: Perel, Pablo Roberto. No especifíca; - Materia
-
Cardiovascular Disease
Latin America
Prognostic Models
Caribbean - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by/2.5/ar/
- Repositorio
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/147918
Ver los metadatos del registro completo
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Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic ReviewCarrillo Larco, Rodrigo M.Altez Fernandez, CarlosPacheco Barrios, NielsBambs, ClaudiaIrazola, VilmaMiranda, J. JaimeMiranda, J. JaimeDanaei, GoodarzPerel, Pablo RobertoCardiovascular DiseaseLatin AmericaPrognostic ModelsCaribbeanhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: Cardiovascular prognostic models guide treatment allocation and support clinical decisions. Whether there are valid models for Latin American and Caribbean (LAC) populations is unknown. Objective: This study sought to identify and critically appraise cardiovascular prognostic models developed, tested, or recalibrated in LAC populations. Methods: The systematic review followed the CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies) framework (PROSPERO [International Prospective Register of Systemic Reviews]: CRD42018096553). Reports were included if they followed a prospective design and presented a multivariable prognostic model; reports were excluded if they studied symptomatic individuals or patients. The following search engines were used: EMBASE, MEDLINE, Scopus, SciELO, and LILACS. Risk of bias assessment was conducted with PROBAST (Prediction model Risk Of Bias ASsessment Tool). No quantitative summary was conducted due to large heterogeneity. Results: From 2,506 search results, 8 studies (N = 130,482 participants) were included for qualitative synthesis. We could not identify any cardiovascular prognostic model developed for LAC populations; reviewed reports evaluated available models or conducted a recalibration analysis. Only 1 study included a Caribbean population (Puerto Rico); 3 studies were retrieved from Chile; 2 from Argentina, Brazil, Colombia, and Uruguay; and 1 from Mexico. Four studies included population-based samples, and the other 4 included people affiliated to a health facility (e.g., prevention clinics). Most studied participants were older than 50 years, and there were more women in 5 reports. The Framingham model was assessed 6 times, and the American College of Cardiology/American Heart Association pooled equation was assessed twice. Across the prognostic models assessed, calibration varied widely from one population to another, showing great overestimation particularly in some subgroups (e.g., highest risk). Discrimination (e.g., C-statistic) was acceptable for most models; for Framingham it ranged from 0.66 to 0.76. The American College of Cardiology/American Heart Association pooled equation showed the best discrimination (0.78). That there were few outcome events was the most important methodological limitation of the identified studies. Conclusions: No cardiovascular prognostic models have been developed in LAC, hampering key evidence to inform public health and clinical practice. Validation studies need to improve methodological issues.Fil: Carrillo Larco, Rodrigo M.. Imperial College London; Reino UnidoFil: Altez Fernandez, Carlos. Universidad Peruana Cayetano Heredia; PerúFil: Pacheco Barrios, Niels. Universidad Peruana Cayetano Heredia; PerúFil: Bambs, Claudia. Pontificia Universidad Católica de Chile; ChileFil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; PerúFil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; PerúFil: Danaei, Goodarz. Harvard University. Harvard School of Public Health; Estados UnidosFil: Perel, Pablo Roberto. No especifíca;Elsevier2019-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/147918Carrillo Larco, Rodrigo M.; Altez Fernandez, Carlos; Pacheco Barrios, Niels; Bambs, Claudia; Irazola, Vilma; et al.; Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review; Elsevier; Global Heart; 14; 1; 3-2019; 81-932211-81602211-8179CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://globalheartjournal.com/article/10.1016/j.gheart.2019.03.001/info:eu-repo/semantics/altIdentifier/doi/10.1016/j.gheart.2019.03.001info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:43:18Zoai:ri.conicet.gov.ar:11336/147918instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:43:19.25CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
dc.title.none.fl_str_mv |
Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review |
title |
Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review |
spellingShingle |
Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review Carrillo Larco, Rodrigo M. Cardiovascular Disease Latin America Prognostic Models Caribbean |
title_short |
Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review |
title_full |
Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review |
title_fullStr |
Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review |
title_full_unstemmed |
Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review |
title_sort |
Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review |
dc.creator.none.fl_str_mv |
Carrillo Larco, Rodrigo M. Altez Fernandez, Carlos Pacheco Barrios, Niels Bambs, Claudia Irazola, Vilma Miranda, J. Jaime Miranda, J. Jaime Danaei, Goodarz Perel, Pablo Roberto |
author |
Carrillo Larco, Rodrigo M. |
author_facet |
Carrillo Larco, Rodrigo M. Altez Fernandez, Carlos Pacheco Barrios, Niels Bambs, Claudia Irazola, Vilma Miranda, J. Jaime Danaei, Goodarz Perel, Pablo Roberto |
author_role |
author |
author2 |
Altez Fernandez, Carlos Pacheco Barrios, Niels Bambs, Claudia Irazola, Vilma Miranda, J. Jaime Danaei, Goodarz Perel, Pablo Roberto |
author2_role |
author author author author author author author |
dc.subject.none.fl_str_mv |
Cardiovascular Disease Latin America Prognostic Models Caribbean |
topic |
Cardiovascular Disease Latin America Prognostic Models Caribbean |
purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.3 https://purl.org/becyt/ford/3 |
dc.description.none.fl_txt_mv |
Background: Cardiovascular prognostic models guide treatment allocation and support clinical decisions. Whether there are valid models for Latin American and Caribbean (LAC) populations is unknown. Objective: This study sought to identify and critically appraise cardiovascular prognostic models developed, tested, or recalibrated in LAC populations. Methods: The systematic review followed the CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies) framework (PROSPERO [International Prospective Register of Systemic Reviews]: CRD42018096553). Reports were included if they followed a prospective design and presented a multivariable prognostic model; reports were excluded if they studied symptomatic individuals or patients. The following search engines were used: EMBASE, MEDLINE, Scopus, SciELO, and LILACS. Risk of bias assessment was conducted with PROBAST (Prediction model Risk Of Bias ASsessment Tool). No quantitative summary was conducted due to large heterogeneity. Results: From 2,506 search results, 8 studies (N = 130,482 participants) were included for qualitative synthesis. We could not identify any cardiovascular prognostic model developed for LAC populations; reviewed reports evaluated available models or conducted a recalibration analysis. Only 1 study included a Caribbean population (Puerto Rico); 3 studies were retrieved from Chile; 2 from Argentina, Brazil, Colombia, and Uruguay; and 1 from Mexico. Four studies included population-based samples, and the other 4 included people affiliated to a health facility (e.g., prevention clinics). Most studied participants were older than 50 years, and there were more women in 5 reports. The Framingham model was assessed 6 times, and the American College of Cardiology/American Heart Association pooled equation was assessed twice. Across the prognostic models assessed, calibration varied widely from one population to another, showing great overestimation particularly in some subgroups (e.g., highest risk). Discrimination (e.g., C-statistic) was acceptable for most models; for Framingham it ranged from 0.66 to 0.76. The American College of Cardiology/American Heart Association pooled equation showed the best discrimination (0.78). That there were few outcome events was the most important methodological limitation of the identified studies. Conclusions: No cardiovascular prognostic models have been developed in LAC, hampering key evidence to inform public health and clinical practice. Validation studies need to improve methodological issues. Fil: Carrillo Larco, Rodrigo M.. Imperial College London; Reino Unido Fil: Altez Fernandez, Carlos. Universidad Peruana Cayetano Heredia; Perú Fil: Pacheco Barrios, Niels. Universidad Peruana Cayetano Heredia; Perú Fil: Bambs, Claudia. Pontificia Universidad Católica de Chile; Chile Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina Fil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; Perú Fil: Miranda, J. Jaime. Universidad Peruana Cayetano Heredia; Perú Fil: Danaei, Goodarz. Harvard University. Harvard School of Public Health; Estados Unidos Fil: Perel, Pablo Roberto. No especifíca; |
description |
Background: Cardiovascular prognostic models guide treatment allocation and support clinical decisions. Whether there are valid models for Latin American and Caribbean (LAC) populations is unknown. Objective: This study sought to identify and critically appraise cardiovascular prognostic models developed, tested, or recalibrated in LAC populations. Methods: The systematic review followed the CHARMS (CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies) framework (PROSPERO [International Prospective Register of Systemic Reviews]: CRD42018096553). Reports were included if they followed a prospective design and presented a multivariable prognostic model; reports were excluded if they studied symptomatic individuals or patients. The following search engines were used: EMBASE, MEDLINE, Scopus, SciELO, and LILACS. Risk of bias assessment was conducted with PROBAST (Prediction model Risk Of Bias ASsessment Tool). No quantitative summary was conducted due to large heterogeneity. Results: From 2,506 search results, 8 studies (N = 130,482 participants) were included for qualitative synthesis. We could not identify any cardiovascular prognostic model developed for LAC populations; reviewed reports evaluated available models or conducted a recalibration analysis. Only 1 study included a Caribbean population (Puerto Rico); 3 studies were retrieved from Chile; 2 from Argentina, Brazil, Colombia, and Uruguay; and 1 from Mexico. Four studies included population-based samples, and the other 4 included people affiliated to a health facility (e.g., prevention clinics). Most studied participants were older than 50 years, and there were more women in 5 reports. The Framingham model was assessed 6 times, and the American College of Cardiology/American Heart Association pooled equation was assessed twice. Across the prognostic models assessed, calibration varied widely from one population to another, showing great overestimation particularly in some subgroups (e.g., highest risk). Discrimination (e.g., C-statistic) was acceptable for most models; for Framingham it ranged from 0.66 to 0.76. The American College of Cardiology/American Heart Association pooled equation showed the best discrimination (0.78). That there were few outcome events was the most important methodological limitation of the identified studies. Conclusions: No cardiovascular prognostic models have been developed in LAC, hampering key evidence to inform public health and clinical practice. Validation studies need to improve methodological issues. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-03 |
dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
format |
article |
status_str |
publishedVersion |
dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/147918 Carrillo Larco, Rodrigo M.; Altez Fernandez, Carlos; Pacheco Barrios, Niels; Bambs, Claudia; Irazola, Vilma; et al.; Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review; Elsevier; Global Heart; 14; 1; 3-2019; 81-93 2211-8160 2211-8179 CONICET Digital CONICET |
url |
http://hdl.handle.net/11336/147918 |
identifier_str_mv |
Carrillo Larco, Rodrigo M.; Altez Fernandez, Carlos; Pacheco Barrios, Niels; Bambs, Claudia; Irazola, Vilma; et al.; Cardiovascular Disease Prognostic Models in Latin America and the Caribbean: A Systematic Review; Elsevier; Global Heart; 14; 1; 3-2019; 81-93 2211-8160 2211-8179 CONICET Digital CONICET |
dc.language.none.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/url/https://globalheartjournal.com/article/10.1016/j.gheart.2019.03.001/ info:eu-repo/semantics/altIdentifier/doi/10.1016/j.gheart.2019.03.001 |
dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by/2.5/ar/ |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by/2.5/ar/ |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
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reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) |
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Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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13.070432 |