title: Prediction models for the risk of cardiovascular disease in patients with type 2 diabetes: a systematic review.
abstract: BACKGROUND
  A recent overview of all CVD models applicable to diabetes patients is not available.
  
  
  OBJECTIVE
  To review the primary prevention studies that focused on the development, validation and impact assessment of a cardiovascular risk model, scores or rules that can be applied to patients with type 2 diabetes.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  Medline was searched from 1966 to 1 April 2011.
  
  
  METHODS
  A study was eligible when it described the development, validation or impact assessment of a model that was constructed to predict the occurrence of cardiovascular disease in people with type 2 diabetes, or when the model was designed for use in the general population but included diabetes as a predictor.
  
  
  METHODS
  A standardized form was sued to extract all data of the CVD models.
  
  
  RESULTS
  45 prediction models were identified, of which 12 were specifically developed for patients with type 2 diabetes. Only 31% of the risk scores has been externally validated in a diabetes population, with an area under the curve ranging from 0.61 to 0.86 and 0.59 to 0.80 for models developed in a diabetes population and in the general population, respectively. Only one risk score has been studied for its effect on patient management and outcomes. 10% of the risk scores are advocated in national diabetes guidelines.
  
  
  CONCLUSIONS
  Many cardiovascular risk scores are available that can be applied to patients with type 2 diabetes. A minority of these risk scores has been validated and tested for its predictive accuracy, with only a few showing a discriminative value of ≥0.80. The impact of applying these risk scores in clinical practice is almost completely unknown, but their use is recommended in various national guidelines.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Str 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands. s.vandieren@umcutrecht.nl
authors.forename: S
authors.initials: S
authors.lastname: van Dieren
authors.forename: J W J
authors.initials: JW
authors.lastname: Beulens
authors.forename: A P
authors.initials: AP
authors.lastname: Kengne
authors.forename: L M
authors.initials: LM
authors.lastname: Peelen
authors.forename: G E H M
authors.initials: GE
authors.lastname: Rutten
authors.forename: M
authors.initials: M
authors.lastname: Woodward
authors.forename: Y T
authors.initials: YT
authors.lastname: van der Schouw
authors.forename: K G M
authors.initials: KG
authors.lastname: Moons
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology; D014943:Global Health; D006801:Humans; D015994:Incidence; D008955:Models, Cardiovascular; D011322:Primary Prevention; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors