Quality assessment of the screening test for predictors of coronary heart disease
https://doi.org/10.29413/ABS.2024-9.3.19
Abstract
Background. Coronary heart disease (CHD) ranks first among the causes of death, morbidity, and disablement. The development of innovative methods for predicting CHD will reduce these losses.
The aim of the work. To assess the quality of the screening test for predictors of coronary heart disease using statistical quality control of a verifiable diagnostic test (with binary outcomes).
Materials and methods. In 2008–2013, 70 cases of CHD were registered in a group
of 7959 initially healthy men 18–66 years old who were the members of locomotive crews. Statistical analysis identified CHD predictors: arterial hypertension; psychosocial stress; hyperglycemia; dyslipidemia; excessive alcohol consumption; obesity of degree I–III; age 34–66 years; microalbuminuria; thickening of the intima- media complex/atherosclerotic plaque (IMC/ASP); pulse wave velocity (PWV) > 12 m/s; left ventricular hypertrophy; grade I–II retinopathy; atherosclerosis of aorta. DiagStat (Russian Federation) software determined their predictive ability when used in screening tests to predict CHD. We demonstrated the use of this method to assess the predictive ability of risk factors for any disease.
Results. CHD predictors have high to moderate specificity for the absence of CHD in individuals who test negative for the above-listed factors. IMC/ASP, microalbuminuria, PWV > 12 m/s, grade III obesity moderately increase the posterior odds of developing CHD versus its absence in comparison with the prior odds after receiving a positive result of the verifiable diagnostic test for these factors. Age 34–66 years moderately increases the posterior odds in favor of the absence of CHD versus its occurrence compared with the prior odds after receiving a negative result of the verifiable diagnostic test.
Conclusion. When assessing the result of the verifiable diagnostic test, we should focus on both the probability of occurrence and the absence of CHD in the presence or absence of a predictor in the patient. Since the determination of PWV > 12 m/s, atherosclerosis of aorta, microalbuminuria, stress, and excessive alcohol consumption among workers of locomotive crews is not mandatory, it is necessary to conduct a targeted search for them
About the Author
A. Yu. Lazutkina
Far Eastern Board of Health, Central Directorate for Healthcare – Branch of the Russian Railways
Russian Federation
Russian Federation
Anna Yu. Lazutkina – Cand. Sc. (Med.), Leading Inspector Physician at the Department of the Organization of Medical Care
Voronezhskaya str. 49, Khabarovsk 680022
References
1. Glushhenko VA, Irklienko EK. Cardiovascular morbidity – one of the most vital problems of modern health care. Medicine and Health Care Organization. 2019; 4(1): 56-63. (In Russ.)
2. Alekseeva AV. Some aspects of the accessibility of medical care for children. Children’s Medicine of the North-West. 2018; 7(1): 18-25. (In Russ.)
3. Zubko AV, Sabgayda TP, Semyonova VG, Muzykantova NN. Mortality associated with preventable causes of deaths from cardio-vascular diseases in the pre-COVID period and during the pandemic in Russia. Social’nye aspekty zdorov’a naselenia. 2023; 69(1): 6. (In Russ.) doi: 10.21045/2071-5021-2023-69-1-6
4. Samorodskaya IV, Klyuchnikov IV. Dynamics of mortality rates from chronic and acute coronary heart disease in the regions of the Russian Federation in 2013–2021. Clinical Medicine (Russian Journal). 2023; 101(7-8): 395-403. (In Russ.) doi: 10.30629/0023-2149-2023-101-7-8-395-403
5. Tsybusov AP. The formation of a healthy lifestyle is a current and urgent task of domestic healthcare. Medical Almanac. 2017; (2): 10-13. (In Russ.)
6. Bichurin DR, Atmaikina OV, Cherepanova OA. Cardiovascular diseases. A regional aspect. International Research Journal. 2023; 134(8). (In Russ.) doi: 10.23670/IRJ.2023.134.103
7. Abrosimov VN, Zhukova LA, Glotov SI, Alekseeva EA. Coronary heart disease: Textbook. Ryazan: Ryazan State Medical University; 2015. (In Russ.)
8. Goma TV. Cardiac ischemia. Angina pectoris: Textbook. Irkutsk: Irkutsk State Medical University; 2022. (In Russ.)
9. Barbarash OL, Karpov YuA, Kashtalap VV, Boshchenko AA, Ruda MM, Akchurin RS, et al. 2020 Clinical practice guidelines for stable coronary artery disease. Russian Journal of Cardiology. 2020; 25(11): 201-250. (In Russ.) doi: 10.15829/1560-4071-2020-4076
10. . On approval of the list of medical contraindications for work directly related to the movement of trains and shunting work: Order of the Ministry of Health and Social Development of the Russian Federation No. 796 d.d. 19.12.2005. 2015. (In Russ.) URL: http://base.consultant.ru дата доступа: 12.02.2024
11. Prilutskaya YuA, Dvoretski LI. The strategy of management patients with non-ST elevation acute coronary syndrome. Kardiologiia. 2019; 59(9): 40-51. (In Russ.) doi: 10.18087/cardio.2019.9.n366
12. Lazutkina AYu. Prediction of cardiovascular diseases and their outcomes among workers of locomotive crews of the TransBaikal Railway (results of a 6-year prospective observation): Abstract of the Thesis of Cand. Sc. (Med.). Chita; 2017. (In Russ.)
13. Boytsov SA, Drapkina OM. Modern content and improvement of high cardiovascular risk strategy in reducing mortality from cardiovascular diseases. Terapevticheskii arkhiv. 2021; 93(1): 4-6. (In Russ.) doi: 10.26442/00403660.2021.01.200543
14. Muraseyeva EV, Gorokhova SG, Prigorovskaya TS, Pfaf VF. On evaluating occupational fitness in railway workers with ventricular arrhythmias after coronary arteries stenting. Russian Journal of Occupational Health and Industrial Ecology. 2016; (4): 1-4. (In Russ.)
15. Abram E. Screening and diagnostic tests. URL: http:// emedicine.medscape.com/article/773832-overview#aw2aab6b5 date of access: 05.02.2023
16. Wіlson JMG, Jungner G. Prіncіples and practіce of screenіng for dіsease. WHO Chronіcle. 1968; 22(11): 473.
17. Lazutkina AYu, Gorbunov VV. Continuum of coronary heart disease. Khabarovsk: DVSMU; 2018. (In Russ.)
18. Diagnosis and treatment of arterial hypertension: recommendations of the Russian Medical Society for Arterial Hypertension and the All-Russian Scientific Society of Cardiology. Cardiovascular Therapy and Prevention. 2008; 7(6 Suppl 2): 1-32. (In Russ.)
19. Cardiovascular prevention: recommendations of the All-Russian Scientific Society of Cardiology. Cardiovascular Therapy and Prevention. 2011; 10(6 Suppl 2): 1-64. (In Russ.)]
20. Petri MA, Sabin K. Visual medical statistics; 2nd edition, revised and enlarged. Moscow: GEOTAR Media; 2010. (In Russ.)
21. Diagnosis and treatment of stable angina: Recommendations of the All-Russian Scientific Society of Cardiology. Moscow; 2009. (In Russ.)
22. Diagnosis and treatment of chronic coronary heart disease: Clinical recommendations of the Ministry of Health of the Russian Federation and the Society of Specialists in Emergency Cardiology and the specialized commission on cardiology. Moscow; 2013. (In Russ.)
23. Recommendations for the treatment of stable coronary heart disease. ESC 2013: European Society of Cardiology clinical guidelines. Russian Journal of Cardiology. 2014; 111(7): 7-79. (In Russ.)
24. Recommendations for the diagnosis and treatment of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). Journal of Hypertension. 2013; 31(7): 1281-1357. (In Russ.)
25. Organization of medical examinations and preventive medical examinations of the adult population: Letter of the Ministry of Health of the Russian Federation No. 14-2/10/2-6432 d.d. 08.29.2013. 2013. (In Russ.)
26. Rumyantsev PO, Saenko VA, Rumyantseva UV, Chekin SYu. Statistical methods for the analyses in clinical practice. Part 2. Survival analysis and multivariate statistics. Problems of Endocrinology. 2009; 55(6): 48-56. (In Russ.) doi: 10.14341/probl200955648-56
27. Tishkov AV, Khromov-Borisov NN, Komashnya AV, Marchenkova FYu, Semenova EM, Eyubova NI, et al. Statistical analysis of 2x2 tables in diagnostic studies. Saint Petersburg: St. Petersburg State Medical University; 2013. (In Russ.)
28. Khromov-Borisov NN, Tishkov AV, Komashnya AV, Marchenkova FYu, Semenova EM. Statistical analysis of clinical studies: 2 × 2 table. Version 1.0: Certificate of state registration of a computer program No. 2012616821. 2012. (In Russ.)
29. Last JM (ed.). Epidemiological dictionary. Moscow: 2009. (In Russ.)
30. Zabolotskikh VV, Vasilyev AV, Tereshchenko YuP. Synergistic effects with simultaneous exposure to physical and chemical factors. Izvestia of Samara Scientific Center of the Russian Academy of Sciences. 2016; 18(5-2): 290-294. (In Russ.)
31. Yakovleva AV. Economic statistics: textbook. Moscow: Exam; 2005. (In Russ.)
32. Tokarev YuA, Sherstobitova GI. Theory of statistics: textbook. Samara: SSTU; 2014. (In Russ.)
33. Porsukov EA. Forensic diagnosis of sudden cardiac death on the background of alcoholic cardiomyopathy. Russian Journal of Forensic Medicine. 2019; 5(3): 42-44. (In Russ.) doi: 10.19048/2411-8729-2019-5-3-42-44
34. Shamray VYu, Makhmutova AM, Erubaeva BB. Comparative analysis of the main risk factors for stroke. Neurosurgery and Neurology of Kazakhstan. 2019; (2): 85-88. (In Russ.)
35. Petrov DV. Diagnosis, treatment and prevention of alcohol use disorders. Yaroslavl; 2002. (In Russ.)
Review
For citations:
Lazutkina A.Yu. Quality assessment of the screening test for predictors of coronary heart disease. Acta Biomedica Scientifica. 2024;9(3):188-202. (In Russ.) https://doi.org/10.29413/ABS.2024-9.3.19
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