Validity of a method for the self-screening of cardiovascular risk
Barroso Sevillano, María (Universitat Autònoma de Barcelona. Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva)
Pérez-Fernández, Silvia (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Vila, M. Mar (Universitat de Barcelona. Departament de Matemàtiques i Informàtica)
Zomeño, María Dolores (Universitat Ramon Llull. Facultat de Ciències de la Salut Blanquerna)
Martí-Lluch, Ruth (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Cordon, Ferran (Institut Català de la Salut. Centre d'Atenció Primària Montilivi (Girona, Catalunya))
Ramos, Rafel (Institut d'Investigació Biomèdica de Girona)
Elosua, Roberto (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Degano, Irene R. (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Fitó, Montserrat (Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición)
Cabezas Peña, Carmen (Agència de Salut Pública de Catalunya)
Salvador, Gemma (Agència de Salut Pública de Catalunya)
Castell, Conxa (Agència de Salut Pública de Catalunya)
Grau, María (Universitat de Barcelona. Departament de Medicina)

Date:	2018
Abstract:	The validity of a cardiovascular risk self-screening method was assessed. The results obtained for self-measurement of blood pressure, a point-of-care system's assessment of lipid profile and glycated hemoglobin, and a self-administered questionnaire (sex, age, diabetes, tobacco consumption) were compared with the standard screening (gold standard) conducted by a health professional. Crossover clinical trial on a population-based sample from Girona (north-eastern Spain), aged 35-74, with no cardiovascular disease at recruitment. Participants were randomized to one of the two risk assessment sequences (standard screening followed by self-screening or vice versa). Cardiovascular risk was estimated with the Framingham-REGICOR function. Concordance between methods was estimated with the intraclass correlation coefficient (ICC). Sensitivity, specificity, and positive and negative predictive values were estimated, considering 5% cardiovascular risk as the cutoff point. Registration #NCT02373319. Clinical Research Ethic Committee of the Parc de Salut Mar Registration #2014/5815/I. The median cardiovascular risk in men was 2. 56 (interquartile range: 1. 42-4. 35) estimated by standard methods and 2. 25 (1. 28-4. 07) by self-screening with ICC=0. 92 (95% CI: 0. 90-0. 93). In women, the cardiovascular risk was 1. 14 (0. 61-2. 10) by standard methods and 1. 10 (0. 56-2. 00) by self-screening, with ICC=0. 89 (0. 87-0. 90). The sensitivity, specificity, and positive and negative predictive values for the self-screening method were 0. 74 (0. 63-0. 82), 0. 97 (0. 95-0. 99), 0. 86 (0. 77-0. 93), and 0. 94 (0. 91-0. 96), respectively, in men. In women, these values were 0. 50 (0. 30-0. 70), 0. 99 (0. 98-1), 0. 81 (0. 54-0. 96), and 0. 97 (0. 95-0. 99), respectively. The self-screening method for assessing cardiovascular risk provided similar results to the standard method. Self-screening had high clinical performance to rule out intermediate or high cardiovascular risk.
Grants:	Instituto de Salud Carlos III CM12/03287 Instituto de Salud Carlos III CPII17/00012 Instituto de Salud Carlos III FIS14/00449
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; Versió publicada
Subject:	Risk assessment ; Cardiovascular diseases ; Preventive medicine ; Public health ; Epidemiology ; Empowerment
Published in:	Clinical Epidemiology, Vol. 10 (may 2018) , p. 549-560, ISSN 1179-1349

DOI: 10.2147/CLEP.S158358
PMID: 29785141

12 p, 1.8 MB

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