Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis

Abstract Background Many prognostic models of diabetic microvascular complications have been developed, but their performances still varies. Therefore, we conducted a systematic review and meta-analysis to summarise the performances of the existing models. Methods Prognostic models of diabetic micro...

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Autores principales:	Sigit Ari Saputro, Oraluck Pattanaprateep, Anuchate Pattanateepapon, Swekshya Karmacharya, Ammarin Thakkinstian
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Meta-analysis Microvascular complications Prognostic model Type 2 diabetes Medicine R
Acceso en línea:	https://doaj.org/article/47518ee4d6274292a0a5e87e8ad41c59
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spelling	oai:doaj.org-article:47518ee4d6274292a0a5e87e8ad41c592021-11-07T12:08:03ZPrognostic models of diabetic microvascular complications: a systematic review and meta-analysis10.1186/s13643-021-01841-z2046-4053https://doaj.org/article/47518ee4d6274292a0a5e87e8ad41c592021-11-01T00:00:00Zhttps://doi.org/10.1186/s13643-021-01841-zhttps://doaj.org/toc/2046-4053Abstract Background Many prognostic models of diabetic microvascular complications have been developed, but their performances still varies. Therefore, we conducted a systematic review and meta-analysis to summarise the performances of the existing models. Methods Prognostic models of diabetic microvascular complications were retrieved from PubMed and Scopus up to 31 December 2020. Studies were selected, if they developed or internally/externally validated models of any microvascular complication in type 2 diabetes (T2D). Results In total, 71 studies were eligible, of which 32, 30 and 18 studies initially developed prognostic model for diabetic retinopathy (DR), chronic kidney disease (CKD) and end stage renal disease (ESRD) with the number of derived equations of 84, 96 and 51, respectively. Most models were derived-phases, some were internal and external validations. Common predictors were age, sex, HbA1c, diabetic duration, SBP and BMI. Traditional statistical models (i.e. Cox and logit regression) were mostly applied, otherwise machine learning. In cohorts, the discriminative performance in derived-logit was pooled with C statistics of 0.82 (0.73‑0.92) for DR and 0.78 (0.74‑0.83) for CKD. Pooled Cox regression yielded 0.75 (0.74‑0.77), 0.78 (0.74‑0.82) and 0.87 (0.84‑0.89) for DR, CKD and ESRD, respectively. External validation performances were sufficiently pooled with 0.81 (0.78‑0.83), 0.75 (0.67‑0.84) and 0.87 (0.85‑0.88) for DR, CKD and ESRD, respectively. Conclusions Several prognostic models were developed, but less were externally validated. A few studies derived the models by using appropriate methods and were satisfactory reported. More external validations and impact analyses are required before applying these models in clinical practice. Systematic review registration PROSPERO CRD42018105287Sigit Ari SaputroOraluck PattanaprateepAnuchate PattanateepaponSwekshya KarmacharyaAmmarin ThakkinstianBMCarticleMeta-analysisMicrovascular complicationsPrognostic modelType 2 diabetesMedicineRENSystematic Reviews, Vol 10, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Meta-analysis Microvascular complications Prognostic model Type 2 diabetes Medicine R
spellingShingle	Meta-analysis Microvascular complications Prognostic model Type 2 diabetes Medicine R Sigit Ari Saputro Oraluck Pattanaprateep Anuchate Pattanateepapon Swekshya Karmacharya Ammarin Thakkinstian Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis
description	Abstract Background Many prognostic models of diabetic microvascular complications have been developed, but their performances still varies. Therefore, we conducted a systematic review and meta-analysis to summarise the performances of the existing models. Methods Prognostic models of diabetic microvascular complications were retrieved from PubMed and Scopus up to 31 December 2020. Studies were selected, if they developed or internally/externally validated models of any microvascular complication in type 2 diabetes (T2D). Results In total, 71 studies were eligible, of which 32, 30 and 18 studies initially developed prognostic model for diabetic retinopathy (DR), chronic kidney disease (CKD) and end stage renal disease (ESRD) with the number of derived equations of 84, 96 and 51, respectively. Most models were derived-phases, some were internal and external validations. Common predictors were age, sex, HbA1c, diabetic duration, SBP and BMI. Traditional statistical models (i.e. Cox and logit regression) were mostly applied, otherwise machine learning. In cohorts, the discriminative performance in derived-logit was pooled with C statistics of 0.82 (0.73‑0.92) for DR and 0.78 (0.74‑0.83) for CKD. Pooled Cox regression yielded 0.75 (0.74‑0.77), 0.78 (0.74‑0.82) and 0.87 (0.84‑0.89) for DR, CKD and ESRD, respectively. External validation performances were sufficiently pooled with 0.81 (0.78‑0.83), 0.75 (0.67‑0.84) and 0.87 (0.85‑0.88) for DR, CKD and ESRD, respectively. Conclusions Several prognostic models were developed, but less were externally validated. A few studies derived the models by using appropriate methods and were satisfactory reported. More external validations and impact analyses are required before applying these models in clinical practice. Systematic review registration PROSPERO CRD42018105287
format	article
author	Sigit Ari Saputro Oraluck Pattanaprateep Anuchate Pattanateepapon Swekshya Karmacharya Ammarin Thakkinstian
author_facet	Sigit Ari Saputro Oraluck Pattanaprateep Anuchate Pattanateepapon Swekshya Karmacharya Ammarin Thakkinstian
author_sort	Sigit Ari Saputro
title	Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis
title_short	Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis
title_full	Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis
title_fullStr	Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis
title_full_unstemmed	Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis
title_sort	prognostic models of diabetic microvascular complications: a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/47518ee4d6274292a0a5e87e8ad41c59
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Prognostic models of diabetic microvascular complications: a systematic review and meta-analysis

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