Discrimination and Calibration of the Veterans Aging Cohort Study Index 2.0 for Predicting Mortality Among People With Human Immunodeficiency Virus in North America
| Autor: | Lucas Gerace, Michael J. Silverberg, Charles S. Rabkin, Viviane D. Lima, Constance A. Benson, Maile Y. Karris, Peter F Rebeiro, M. John Gill, Meenakshi Gupta, Vincent C. Marconi, Cameron Stewart, Stephen E. Van Rompaey, Richard D. Moore, William B. Lober, Megan Turner, Janet P. Tate, Julio S. G. Montaner, Adrian Betts, Aimee M. Freeman, Joseph J. Eron, Ronald J. Bosch, Todd T. Brown, Michael S. Saag, Amy C. Justice, Angel M. Mayor, Abigail Kroch, Michael J. Mugavero, Laura Bamford, Joanne Lindsay, Brenna C. Hogan, Mari M. Kitahata, Jun Li, Jeffrey M. Jacobson, Jennifer E. Thorne, Kate Salters, Kathleen A. McGinnis, Chris Grasso, Kate Buchacz, Jonathan Colasanti, Mona Loutfy, James H. Willig, Liz Morton, Gypsyamber D'Souza, Kenneth H. Mayer, Jennifer S. Lee, Rosemary G. McKaig, Kelly A. Gebo, Michael A. Horberg, Stephen J. Gange, Robert S. Hogg, Ank E. Nijhawan, Elizabeth Humes, Justin McReynolds, Timothy R. Sterling, Keri N. Althoff, Paul Sereda, Sonia Napravnik, Graham Smith, Gregory D. Kirk, David W. Haas, Ann N. Burchell, Sally B. Coburn, Bin You, Phyllis C. Tien, Angel M Mayor, Marina B. Klein, Jeffrey N. Martin, John T. Brooks, Heidi M. Crane |
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| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Male Aging Index (economics) Calibration (statistics) HIV Infections 030204 cardiovascular system & hematology National Death Index Cohort Studies 03 medical and health sciences 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Risk of mortality Major Article Medicine Humans 030212 general & internal medicine Veterans business.industry Mortality rate HIV Middle Aged medicine.disease 3. Good health Infectious Diseases Cohort Calibration North America Female business Cohort study Demography |
| Zdroj: | Clin Infect Dis |
| ISSN: | 1537-6591 |
| Popis: | Background The updated Veterans Aging Cohort Study (VACS) Index 2.0 combines general and human immunodeficiency virus (HIV)–specific biomarkers to generate a continuous score that accurately discriminates risk of mortality in diverse cohorts of persons with HIV (PWH), but a score alone is difficult to interpret. Using data from the North American AIDS Cohort Collaboration (NA-ACCORD), we translate VACS Index 2.0 scores into validated probability estimates of mortality. Methods Because complete mortality ascertainment is essential for accurate calibration, we restricted analyses to cohorts with mortality from the National Death Index or equivalent sources. VACS Index 2.0 components were ascertained from October 1999 to April 2018. Mortality was observed up to March 2019. Calibration curves compared predicted (estimated by fitting a gamma model to the score) to observed mortality overall and within subgroups: cohort (VACS/NA-ACCORD subset), sex, age 500 copies/mL, CD4 count Results Among 37230 PWH in VACS and 8061 PWH in the NA-ACCORD subset, median age was 53 and 44 years; 3% and 19% were women; and 48% and 39% were black. Discrimination in NA-ACCORD (C-statistic = 0.842 [95% confidence interval {CI}, .830–.854]) was better than in VACS (C-statistic = 0.813 [95% CI, .809–.817]). Predicted and observed mortality largely overlapped in VACS and the NA-ACCORD subset, overall and within subgroups. Conclusions Based on this validation, VACS Index 2.0 can reliably estimate probability of all-cause mortality, at various follow-up times, among PWH in North America. |
| Databáze: | OpenAIRE |
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