Journal article
A Risk Prediction Model for Mortality Among Smokers in the COPDGene® Study
Chronic obstructive pulmonary diseases, Vol.7(4), pp.346-361
10/25/2020
DOI: 10.15326/jcopdf.7.4.2020.0146
PMCID: PMC7883903
PMID: 32877963
Abstract
Background:
Risk factor identification is a proven strategy in advancing treatments and preventive therapy for many chronic conditions. Quantifying the impact of those risk factors on health outcomes can consolidate and focus efforts on individuals with specific high-risk profiles. Using multiple risk factors and longitudinal outcomes in 2 independent cohorts, we developed and validated a risk score model to predict mortality in current and former cigarette smokers.
Methods:
We obtained extensive data on current and former smokers from the COPD Genetic Epidemiology (COPDGene
®
) study at enrollment. Based on physician input and model goodness-of-fit measures, a subset of variables was selected to fit final Weibull survival models separately for men and women. Coefficients and predictors were translated into a point system, allowing for easy computation of mortality risk scores and probabilities. We then used the SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS) cohort for external validation of our model.
Results:
Of 9867 COPDGene participants with standard baseline data, 17.6% died over 10 years of follow-up, and 9074 of these participants had the full set of baseline predictors (standard plus 6-minute walk distance and computed tomography variables) available for full model fits. The average age of participants in the cohort was 60 for both men and women, and the average predicted 10-year mortality risk was 18% for women and 25% for men. Model time-integrated area under the receiver operating characteristic curve statistics demonstrated good predictive model accuracy (0.797 average), validated in the external cohort (0.756 average). Risk of mortality was impacted most by 6-minute walk distance, forced expiratory volume in 1 second and age, for both men and women.
Conclusions:
Current and former smokers exhibited a wide range of mortality risk over a 10- year period. Our models can identify higher risk individuals who can be targeted for interventions to reduce risk of mortality, for participants with or without chronic obstructive pulmonary disease (COPD) using current Global initiative for chronic Obstructive Lung Disease (GOLD) criteria.
Details
- Title: Subtitle
- A Risk Prediction Model for Mortality Among Smokers in the COPDGene® Study
- Creators
- Matthew Strand - National Jewish HealthErin Austin - University of Colorado DenverMatthew Moll - Brigham and Women's HospitalKatherine A. Pratte - National Jewish HealthElizabeth A. Regan - National Jewish HealthLystra P. Hayden - Brigham and Women's HospitalSurya P. Bhatt - University of Alabama at BirminghamAladin M. Boriek - Baylor College of MedicineRichard Casaburi - The Lundquist InstituteEdwin K. Silverman - Brigham and Women's HospitalSpyridon Fortis - University of IowaIngo Ruczinski - Johns Hopkins UniversityHarald Koegler - Boehringer IngelheimHarry B. Rossiter - University of California, Los AngelesMariaelena Occhipinti - University of FlorenceNicola A. Hanania - Baylor College of MedicineHirut T. Gebrekristos - Morehouse School of MedicineDavid A. Lynch - National Jewish HealthKen M. Kunisaki - United States Department of Veterans AffairsKendra A. Young - University of Colorado Anschutz Medical CampusJessica C. Sieren - University of IowaMargaret Ragland - University of Colorado Anschutz Medical CampusJohn E. Hokanson - University of Colorado Anschutz Medical CampusSharon M. Lutz - Harvard Medical School Harvard University Boston MassachusettsBarry J. Make - National Jewish HealthGregory L. Kinney - University of Colorado Anschutz Medical CampusMichael H. Cho - Brigham and Women's HospitalMassimo Pistolesi - University of FlorenceDawn L. DeMeo - Harvard UniversityFrank C. Sciurba - University of PittsburghAlejandro P. Comellas - University of IowaAlejandro A. Diaz - Brigham and Women's HospitalIgor Barjaktarevic - University of California, Los AngelesRussell P. Bowler - National Jewish HealthRichard E. Kanner - University of UtahStephen P. Peters - Wake Forest UniversityVictor E. Ortega - Wake Forest UniversityMark T. Dransfield - University of Alabama at BirminghamJames D. Crapo - National Jewish Health
- Resource Type
- Journal article
- Publication Details
- Chronic obstructive pulmonary diseases, Vol.7(4), pp.346-361
- DOI
- 10.15326/jcopdf.7.4.2020.0146
- PMID
- 32877963
- PMCID
- PMC7883903
- NLM abbreviation
- Chronic Obstr Pulm Dis
- ISSN
- 2372-952X
- eISSN
- 2372-952X
- Publisher
- COPD Foundation Inc
- Alternative title
- A Risk Prediction Model for Mortality Among Smokers
- Language
- English
- Date published
- 10/25/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Pulmonary, Critical Care, and Occupational Medicine; Psychiatry; ICTS; Internal Medicine
- Record Identifier
- 9984318724202771
Metrics
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