Optimal risk-assessment scheduling for primary prevention of cardiovascular disease

TL;DR

This paper proposes a personalized, age-specific scheduling method for cardiovascular risk assessments, optimizing timing based on individual risk profiles and benefits to improve prevention strategies.

Contribution

It introduces a novel Net Benefit function and extends the landmarking model to estimate patient-specific CVD risk profiles with time-varying covariates.

Findings

Lower-risk individuals may need assessments every 5 years or more.

Time-varying risk factors are essential for higher-risk group scheduling.

The model was validated using UK primary care electronic health records.

Abstract

In this work, we introduce a personalised and age-specific Net Benefit function, composed of benefits and costs, to recommend optimal timing of risk assessments for cardiovascular disease prevention. We extend the 2-stage landmarking model to estimate patient-specific CVD risk profiles, adjusting for time-varying covariates. We apply our model to data from the Clinical Practice Research Datalink, comprising primary care electronic health records from the UK. We find that people at lower risk could be recommended an optimal risk-assessment interval of 5 years or more. Time-varying risk-factors are required to discriminate between more frequent schedules for higher-risk people.