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- Hageman, S., et al.
(författare)
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SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe
- 2021
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 42:25, s. 2439-2454
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Tidskriftsartikel (refereegranskat)abstract
- Aims The aim of this study was to develop, validate, and illustrate an updated prediction model (SCORE2) to estimate 10-year fatal and non-fatal cardiovascular disease (CVD) risk in individuals without previous CVD or diabetes aged 40-69 years in Europe. Methods and results We derived risk prediction models using individual-participant data from 45 cohorts in 13 countries (677 684 individuals, 30 121 CVD events). We used sex-specific and competing risk-adjusted models, including age, smoking status, systolic blood pressure, and total- and HDL-cholesterol. We defined four risk regions in Europe according to country-specific CVD mortality, recalibrating models to each region using expected incidences and risk factor distributions. Region-specific incidence was estimated using CVD mortality and incidence data on 10 776 466 individuals. For external validation, we analysed data from 25 additional cohorts in 15 European countries (1 133 181 individuals, 43 492 CVD events). After applying the derived risk prediction models to external validation cohorts, C-indices ranged from 0.67 (0.65-0.68) to 0.81 (0.76-0.86). Predicted CVD risk varied several-fold across European regions. For example, the estimated 10-year CVD risk for a 50-year-old smoker, with a systolic blood pressure of 140 mmHg, total cholesterol of 5.5 mmol/L, and HDL-cholesterol of 1.3 mmol/L, ranged from 5.9% for men in low- risk countries to 14.0% for men in very high-risk countries, and from 4.2% for women in low-risk countries to 13.7% for women in very high-risk countries. Conclusion SCORE2-a new algorithm derived, calibrated, and validated to predict 10-year risk of first-onset CVD in European populations-enhances the identification of individuals at higher risk of developing CVD across Europe.
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| 2. |
- Carlström, Eric, 1957, et al.
(författare)
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Inter-Organisational Exercises in Dry and Wet Context-Why Do Maritime Response Organisations Gain More Knowledge from Exercises at Sea Than Those on Shore?
- 2020
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Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 12:14
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Tidskriftsartikel (refereegranskat)abstract
- This is a study of inter-organisational exercises arranged by on-shore organisations (ONSOs) and off-shore organisations (OFFSOs). The aim was to compare findings from trained emergency staffs' perceptions of the impact of exercises. The data were retrieved from surveys conducted by the research team in conjunction with exercises. The surveys included staff from the coast guard, sea rescue, police department, fire department and ambulance services. A total of 94 professional emergency personnel participated in the ONSO exercises and 252 in the OFFSO exercises. The study was based on the suggestion that collaborative elements during an inter-organisational exercise promote learning, and learning is important to make the exercises useful. Collaboration proved to be a predictor for some of the items in learning, and learning was a predictor for some of the items in utility. There was, however, a stronger covariation between collaboration, learning and utility in the OFFSOs exercises than in the ONSOs. One reason might be the different cultures of emergency staff involved in on-shore and off-shore organisations. The OFFSOs' qualifications may be dominated by seamanship, together with professional practice, and all parties are expected to act as first responders. ONSOs, on the other hand, practice exercises from a strict professional and legal perspective.
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