Evidence map›Paper›PMID 34997924›Full record

SynthesisJournal of nephrology2022

External validation of prognostic models for chronic kidney disease among type 2 diabetes.

Sigit Ari Saputro, Anuchate Pattanateepapon, Oraluck Pattanaprateep, Wichai Aekplakorn, Gareth J McKay, John Attia, Ammarin Thakkinstian

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Journal of nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 4 countries.

Sigit Ari SaputroDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand.
Anuchate PattanateepaponDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand. anuchate.gab@mahidol.ac.th.ORCID 0000-0003-1246-9482
Oraluck PattanaprateepDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand.
Wichai AekplakornDepartment of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand. wichai.aek@mahidol.ac.th.
Gareth J McKayCentre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
John AttiaSchool of Medicine and Public Health, and Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, Australia.
Ammarin ThakkinstianDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Phayathai, Bangkok, 10400, Thailand.
Mahidol University · THAirlangga University · IDHunter Medical Research Institute · AUQueen's University Belfast · GB

Funding

Medical Research Council MC_PC_22005Medical Research Council MR/K003364/1
6 · The paper itself

Abstract

backgroundVarious prognostic models have been derived to predict chronic kidney disease (CKD) development in type 2 diabetes (T2D). However, their generalisability and predictive performance in different populations remain largely unvalidated. This study aimed to externally validate several prognostic models of CKD in a T2D Thai cohort.

methodsA nationwide survey was linked with hospital databases to create a prospective cohort of patients with diabetes (n = 3416). We undertook a systematic review to identify prognostic models and traditional metrics (i.e., discrimination and calibration) to compare model performance for CKD prediction. We updated prognostic models by including additional clinical parameters to optimise model performance in the Thai setting.

resultsSix relevant previously published models were identified. At baseline, C-statistics ranged from 0.585 (0.565-0.605) to 0.786 (0.765-0.806) for CKD and 0.657 (0.610-0.703) to 0.760 (0.705-0.816) for end-stage renal disease (ESRD). All original CKD models showed fair calibration with Observed/Expected (O/E) ratios ranging from 0.999 (0.975-1.024) to 1.009 (0.929-1.090). Hosmer-Lemeshow tests indicated a good fit for all models. The addition of routine clinical factors (i.e., glucose level and oral diabetes medications) enhanced model prediction by improved C-statistics of Low's of 0.114 for CKD and Elley's of 0.025 for ESRD.

conclusionsAll models showed moderate discrimination and fair calibration. Updating models to include routine clinical factors substantially enhanced their accuracy. Low's (developed in Singapore) and Elley's model (developed in New Zealand), outperformed the other models evaluated. These models can assist clinicians to improve the risk-stratification of diabetic patients for CKD and/or ESRD in the regions settings are similar to Thailand.

Indexed as

Diabetes Mellitus, Type 2Kidney Failure, ChronicRenal Insufficiency, ChronicHumansPrognosisProspective StudiesRisk AssessmentRisk FactorsChronic kidney diseaseExternal validationPrognostic modelType 2 Diabetes

Identifiers

PMID34997924
PMCPMC9300508
OpenAlexW4206058735

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.