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
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/147918

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network_name_str CONICET Digital (CONICET)
spelling 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
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dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
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instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv 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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