All Subsets Regression in a Proportional Hazards Model

Kuk, Anthony Y. C.

doi:10.2307/2336568

Cited by 16 publications

(19 citation statements)

References 5 publications

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“…Selection of predictor variables used the backward elimination method. The same results were obtained with the exhaustive search method 22. Discrimination was assessed with the c statistic, which shows the ability of the model to discriminate subjects with the outcome from those without the outcome.…”

Section: Methodsmentioning

confidence: 83%

Rates and predictors of risk of stroke and its subtypes in diabetes: a prospective observational study

Hankey

Anderson

Ting

et al. 2012

Journal of Neurology, Neurosurgery & Psychiatry

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Section: Methodsmentioning

confidence: 83%

Rates and predictors of risk of stroke and its subtypes in diabetes: a prospective observational study

Hankey

Anderson

Ting

et al. 2012

Journal of Neurology, Neurosurgery & Psychiatry

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“…A basic risk model was developed to identify the most important predictors of amputations. Variables in the model were initially determined by use of backwards selection of all baseline characteristics in table 1 plus fibrinogen and homocysteine in a proportional hazards model, and then confirmed by exhaustive search methods 14 . The possibility of over-fitting because of the large number of potential predictors assessed and the small number of events was examined by calculating the heuristic shrinkage factor 11 .…”

Section: Methodsmentioning

confidence: 99%

Effect of fenofibrate on amputation events in people with type 2 diabetes mellitus (FIELD study): a prespecified analysis of a randomised controlled trial

et al. 2009

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SummaryBackgroundAmputations in people with type 2 diabetes mellitus substantially impair their quality of life and impose high costs on health-care systems. Our aim was to assess the effect of fenofibrate on amputation events in a large cohort of patients with type 2 diabetes.MethodsIn the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, 9795 patients aged 50–75 years with type 2 diabetes were randomly assigned by computer-generated randomisation sequence to receive fenofibrate 200 mg per day (n=4895) or matching placebo (n=4900) for 5 years' duration. Information about non-traumatic amputation—a prespecified tertiary endpoint of the study—was routinely gathered. Clinicians who were masked to treatment allocation adjudicated amputations as minor or major (below or above the ankle, respectively). Amputations were also classified on the basis of whether or not large-vessel disease was present in the limb, to distinguish those related to large-artery atherosclerosis from those predominantly related to microvascular disease. Analysis was by intention to treat (ITT). The FIELD study is registered as an International Standard Randomised Controlled Trial, number ISRCTN64783481.FindingsAll 9795 patients were included in the ITT population. 115 patients had one or more non-traumatic lower-limb amputations due to diabetes. Previous cardiovascular disease, microvascular disease, previous non-traumatic amputation or skin ulcer, smoking, and longer duration of diabetes were more frequent in patients who had amputations during the trial than in those who had other cardiovascular events or in those who had neither event (all p<0·001 for three-way comparison). Mean lipid concentrations differed between patients who had on-study amputations and those who had other cardiovascular events or neither event, but by no more than 0·2 mmol/L. The risks of first amputation (45 vs 70 events; hazard ratio [HR] 0·64, 95% CI 0·44–0·94; p=0·02) and minor amputation events without known large-vessel disease (18 vs 34 events; 0·53, 0·30–0·94; p=0·027) were lower for patients assigned to fenofibrate than for patients assigned to placebo, with no difference between groups in risk of major amputations (24 vs 26 events; 0·93, 0·53–1·62; p=0·79).InterpretationClassic markers of macrovascular and microvascular risk were associated with lower extremity amputations in patients with type 2 diabetes. Treatment with fenofibrate was associated with a lower risk of amputations, particularly minor amputations without known large-vessel disease, probably through non-lipid mechanisms. These findings could lead to a change in standard treatment for the prevention of diabetes-related lower-limb amputations.FundingLaboratoires Fournier SA (now part of Solvay Pharmaceuticals) and National Health and Medical Research Council of Australia.

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“…In analyses involving only the placebo group, Kaplan-Meier curves were constructed on the basis of baseline renal status up until 2 years, after which a landmark analysis from this point using updated renal status (remained normal/abnormal or changed) was performed. Additionally, the Harrell-Lee c-index [22] was used to quantify the global performance of the various risk models for CVD that were identified by an exhaustive search Cox regression analysis [23]. This allowed identifi- ) were more likely than the 9,276 group 1 and 2 patients (eGFR ≥60 ml min −1 1.73 m −2 ) to be women and older, and to have longer diabetes duration and higher blood pressure (Table 1).…”

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confidence: 99%

Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

et al. 2010

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Aims/hypothesis We investigated effects of renal function and albuminuria on cardiovascular outcomes in 9,795 lowrisk patients with diabetes in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. Methods Baseline and year 2 renal status were examined in relation to clinical and biochemical characteristics. Outcomes included total cardiovascular disease (CVD), cardiac and non-cardiac death over 5 years. Results Lower estimated GFR (eGFR) vs eGFR ≥90 ml min . CVD risk was further modified by renal status changes over the first 2 years. In multivariable analysis, 77% of the effect of eGFR and 81% of the effect of albumin:creatinine ratio were accounted for by other variables, principally low HDL-cholesterol and elevated blood pressure. Conclusions/interpretation Reduced eGFR and albuminuria are independent risk factors for cardiovascular events and mortality rates in a low-risk population of mainly European ancestry. While their independent contributions to CVD risk appear small when other risk factors are considered, they remain excellent surrogate markers in clinical practice because they capture risk related to a number of other characteristics. Therefore, both should be considered when assessing prognosis and treatment strategies in patients with diabetes, and both should be included in risk models.

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All Subsets Regression in a Proportional Hazards Model

Cited by 16 publications

References 5 publications

Rates and predictors of risk of stroke and its subtypes in diabetes: a prospective observational study

Rates and predictors of risk of stroke and its subtypes in diabetes: a prospective observational study

Effect of fenofibrate on amputation events in people with type 2 diabetes mellitus (FIELD study): a prespecified analysis of a randomised controlled trial

Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study

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