Artículo
The psychosis metabolic risk calculator (PsyMetRiC) for young people with psychosis: International external validation and site-specific recalibration in two independent European samples
Autor/es | Perry, Benjamin I.
Vandenberghe, Frederik Garrido Torres, Nathalia Osimo, Emanuele F. Piras, Marianna Vázquez-Bourgon, Javier Ruiz Veguilla, Miguel Crespo Facorro, Benedicto |
Departamento | Universidad de Sevilla. Departamento de Psiquiatría |
Fecha de publicación | 2022-08-19 |
Fecha de depósito | 2023-05-29 |
Publicado en |
|
Resumen | Background
Cardiometabolic dysfunction is common in young people with psychosis. Recently, the Psychosis Metabolic Risk Calculator (PsyMetRiC) was developed and externally validated in the UK, predicting up-to six-year ... Background Cardiometabolic dysfunction is common in young people with psychosis. Recently, the Psychosis Metabolic Risk Calculator (PsyMetRiC) was developed and externally validated in the UK, predicting up-to six-year risk of metabolic syndrome (MetS) from routinely collected data. The full-model includes age, sex, ethnicity, body-mass index, smoking status, prescription of metabolically-active antipsychotic medication, high-density lipoprotein, and triglyceride concentrations; the partial-model excludes biochemical predictors. Methods To move toward a future internationally-useful tool, we externally validated PsyMetRiC in two independent European samples. We used data from the PsyMetab (Lausanne, Switzerland) and PAFIP (Cantabria, Spain) cohorts, including participants aged 16–35y without MetS at baseline who had 1–6y follow-up. Predictive performance was assessed primarily via discrimination (C-statistic), calibration (calibration plots), and decision curve analysis. Site-specific recalibration was considered. Findings We included 1024 participants (PsyMetab n=558, male=62%, outcome prevalence=19%, mean follow-up=2.48y; PAFIP n=466, male=65%, outcome prevalence=14%, mean follow-up=2.59y). Discrimination was better in the full- compared with partial-model (PsyMetab=full-model C=0.73, 95% C.I., 0.68–0.79, partial-model C=0.68, 95% C.I., 0.62–0.74; PAFIP=full-model C=0.72, 95% C.I., 0.66–0.78; partial-model C=0.66, 95% C.I., 0.60–0.71). As expected, calibration plots revealed varying degrees of miscalibration, which recovered following site-specific recalibration. PsyMetRiC showed net benefit in both new cohorts, more so after recalibration. Interpretation The study provides evidence of PsyMetRiC's generalizability in Western Europe, although further local and international validation studies are required. In future, PsyMetRiC could help clinicians internationally to identify young people with psychosis who are at higher cardiometabolic risk, so interventions can be directed effectively to reduce long-term morbidity and mortality. |
Agencias financiadoras | Junta de Andalucía Instituto de Salud Carlos III Fundación Marqués de Valdecilla IDIVAL Ministerio de Economía y Competitividad (MINECO). España European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER) NIHR Cambridge Biomedical Research Centre SENY Fundacion Research Swiss National Research Foundation Wellcome Trust |
Identificador del proyecto | BRC-1215-20014
201486/Z/16/Z 320030-120686 324730- 144064 320030-173211 CM20/00015 FIS00/3095 PI020499 PI050427 PI060507 INT/A21/10 INT/A20/04 A1-0055-2020 A1-0005-2021 2005-0308007 A/02/07 API07/011 SAF2016-76046-R SAF2013-46292-R |
Cita | Perry, B.I., Vandenberghe, F., Garrido Torres, N., Osimo, E.F., Piras, M., Vázquez-Bourgon, J.,...,Crespo Facorro, B. (2022). The psychosis metabolic risk calculator (PsyMetRiC) for young people with psychosis: International external validation and site-specific recalibration in two independent European samples. The Lancet Regional Health Europe, 22, 100493. https://doi.org/10.1016/j.lanepe.2022.100493. |
Ficheros | Tamaño | Formato | Ver | Descripción |
---|---|---|---|---|
The psychosis metabolic risk ... | 735.9Kb | [PDF] | Ver/ | |