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The addition of depression to the Framingham Risk Equation model for predicting coronary heart disease risk in women

O'Neil, Adrienne, Fisher, Aaron J., Kibbey, Katherine J., Jacka, Felice N., Kotowicz, Mark A., Williams, Lana J., Stuart, Amanda L., Berk, Michael, Lewandowski, Paul A., Atherton, John J., Taylor, Craig B. and Pasco, Julie A. 2016, The addition of depression to the Framingham Risk Equation model for predicting coronary heart disease risk in women, Preventive medicine, vol. 87, pp. 115-120, doi: 10.1016/j.ypmed.2016.02.028.

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Title The addition of depression to the Framingham Risk Equation model for predicting coronary heart disease risk in women
Author(s) O'Neil, Adrienne
Fisher, Aaron J.
Kibbey, Katherine J.
Jacka, Felice N.
Kotowicz, Mark A.
Williams, Lana J.
Stuart, Amanda L.
Berk, Michael
Lewandowski, Paul A.
Atherton, John J.
Taylor, Craig B.
Pasco, Julie A.
Journal name Preventive medicine
Volume number 87
Start page 115
End page 120
Total pages 6
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-06
ISSN 1096-0260
Keyword(s) Coronary heart disease
Depression
Prevention
Risk factor assessment
Women
Summary BACKGROUND: Depression is widely considered to be an independent and robust predictor of Coronary Heart Disease (CHD), however is seldom considered in the context of formal risk assessment. We assessed whether the addition of depression to the Framingham Risk Equation (FRE) improved accuracy for predicting 10-year CHD in a sample of women.

DESIGN: A prospective, longitudinal design comprising an age-stratified, population-based sample of Australian women collected between 1993 and 2011 (n=862).

METHODS: Clinical depressive disorder was assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID-I/NP), using retrospective age-of-onset data. A composite measure of CHD included non-fatal myocardial infarction, unstable angina coronary intervention or cardiac death. Cox proportional-hazards regression models were conducted and overall accuracy assessed using area under receiver operating characteristic (ROC) curve analysis.

RESULTS: ROC curve analyses revealed that the addition of baseline depression status to the FRE model improved its overall accuracy (AUC:0.77, Specificity:0.70, Sensitivity:0.75) when compared to the original FRE model (AUC:0.75, Specificity:0.73, Sensitivity:0.67). However, when calibrated against the original model, the predicted number of events generated by the augmented version marginally over-estimated the true number observed.

CONCLUSIONS: The addition of a depression variable to the FRE equation improves the overall accuracy of the model for predicting 10-year CHD events in women, however may over-estimate the number of events that actually occur. This model now requires validation in larger samples as it could form a new CHD risk equation for women.
Language eng
DOI 10.1016/j.ypmed.2016.02.028
Field of Research 110319 Psychiatry (incl Psychotherapy)
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2016, Elsevier
Free to Read? No
Free to Read Start Date 2017-07-01
Persistent URL http://hdl.handle.net/10536/DRO/DU:30082038

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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