Agreement between the SCORE and D’Agostino Scales for the Classification of High Cardiovascular Risk in Sedentary Spanish Patients

Abstract

Background:To evaluate agreement between cardiovascular risk in sedentary patients as estimated by the new Framingham-D’Agostino scale and by the SCORE chart, and to describe the patient characteristics associated with the observed disagreement between the scales.Design:A cross-sectional study was undertaken involving a systematic sample of 2,295 sedentary individuals between 40–65 years of age seen for any reason in 56 primary care offices. An estimation was made of the Pearson correlation coefficient and kappa statistic for the classification of high risk subjects (≥20% according to the Framingham-D’Agostino scale, and ≥5% according to SCORE). Polytomous logistic regression models were fitted to identify the variables associated with the discordance between the two scales.Results:The mean risk in males (35%) was 19.5% ± 13% with D’Agostino scale, and 3.2% ± 3.3% with SCORE. Among females, they were 8.1% ± 6.8% and 1.2% ± 2.2%, respectively. The correlation between the two scales was 0.874 in males (95% CI: 0.857–0.889) and 0.818 in females (95% CI: 0.800–0.834), while the kappa index was 0.50 in males (95% CI: 0.44%–0.56%) and 0.61 in females (95% CI: 0.52%–0.71%). The most frequent disagreement, characterized by high risk according to D’Agostino scale but not according to SCORE, was much more prevalent among males and proved more probable with increasing age and increased LDL-cholesterol, triglyceride and systolic blood pressure values, as well as among those who used antihypertensive drugs and smokers.Conclusions:The quantitative correlation between the two scales is very high. Patient categorization as corresponding to high risk generates disagreements, mainly among males, where agreement between the two classifications is only moderate.

Change of water consumption and its potential influential factors in Shanghai: A cross-sectional study

“…Agreement between domestic drinking water type and what one believed to be the cleanest was qualitatively assessed by the kappa statistic. Kappa values of 0.81–1 were interpreted as excellent agreement, 0.61–0.80 as good, 0.41–0.60 as moderate, 0.21–0.40 as slight, and 0–0.20 as poor [24]. Statistical analysis was performed with Stata/SE 11.0 (College Station, TX).…”

Concordancia entre escalas Framingham ATP III, Score y ACC/AHA 2013 en una cohorte de pacientes en un hospital de cuarto nivel en el año 2015

“…Se tuvo en cuenta el tipo de análisis que se quiere realizar que es de concordancia mediante el índice de Kappa. Se consideró concordancia clínicamente importante para Kappa ≥ 0.6, esto a raíz de que en los trabajos realizados previamente de concordancia, los índices más altos fueron al comparar Framingham y ACC/AHA 2013 con Kappa = 0.5735 al comparar la indicación farmacológica (6) y Framingham-D'Agostino y SCORE con Kappa: 0.52 para alto riesgo cardiovascular (10). Con un error máximo permitido de 5% una confianza de 95% un poder estadístico de 80 y estimando la concordancia con el índice kappa de 50%, es decir desconocido, el tamaño de muestra necesario fue de 861 sujetos.…”

“…Debido a los niveles de concordancia moderada frente a la recomendación de manejo farmacológico se planteó realizar el ejercicio de concordancia entre las tres escalas mencionadas en un grupo poblacional más próximo al tiempo actual y describir las características del grupo poblacional a estudio. Considerando una concordancia clínicamente importante para Kappa: 0.6, esto a raíz de que en los trabajos realizados previamente, los índices de concordancia más altos fueron al comparar Framingham y ACC/AHA 2013 con Kappa = 0.5735 al comparar la indicación farmacológica (6) y Framingham-D'Agostino y SCORE con Kappa : 0.52 para alto riesgo cardiovascular (10).…”