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Methodische Entwicklung von Scores am Beispiel des Diabetes

Methodological development of scores using the example of diabetes

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Der Diabetologe Aims and scope

Zusammenfassung

Hintergrund

In mehreren randomisierten Studien ist gezeigt worden, dass Menschen mit einem hohen Diabetesrisiko von Interventionsmaßnahmen profitieren und das Risiko senken können. Viele Betroffene wissen jedoch nicht, dass sie ein erhöhtes Diabetesrisiko aufweisen. Hier bieten Risikoscores für den Typ-2-Diabetes die Möglichkeit, Personen mit mittlerem und hohem Erkrankungsrisiko frühzeitig zu identifizieren.

Ziel

Im vorliegenden Beitrag wird erläutert, was einen guten Risikoscore auszeichnet. Dies sind neben statistischen Gütekriterien wie Diskriminanz, Kalibrierung und externer Validität auch die Benutzerfreundlichkeit des Scores, die Verfügbarkeit der im Score berücksichtigten Parameter sowie niedrige Kosten. Ferner wird kurz skizziert, wie ein Risikoscore aus Daten von Kohortenstudien abgeleitet wird.

Diskussion

Derzeit besteht eine Vielzahl von verwendbaren Prädiktionsmodellen für den Typ-2-Diabetes. Der Schwerpunkt weiterer Forschung sollte auf der Frage liegen, wie Risikoscores besser in der ärztlichen Praxis verankert werden können.

Abstract

Background

In several randomized studies it has been shown that persons with a high risk of diabetes benefit from lifestyle interventions and can reduce their risk of diabetes. However, many of these persons are unaware of their increased risk of diabetes. Using risk scores it is possible to identify such persons early enough to offer them lifestyle intervention or medication.

Objectives

The purpose of the present work is to explain the characteristics of a good risk score: In addition to statistical quality criteria (e.g., discrimination, calibration and external validation), the ease of use, availability of the parameters in the score, and low costs are essential for a good prediction model. Moreover, it is explained how risk scores are developed from data of cohort studies.

Conclusion

Currently, a great number of prediction models for type 2 diabetes have been developed. Future research should focus on how risk scores could be better implemented in clinical practice.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. B. Kowall und W. Rathmann geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Institut für Biometrie und Epidemiologie, Deutsches Diabetes-Zentrum, Auf‘m Hennekamp 65, 40225, Düsseldorf, Deutschland

    B. Kowall &  W. Rathmann

Authors
  1. B. Kowall
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  2. W. Rathmann
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Correspondence to W. Rathmann.

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Kowall, B., Rathmann, W. Methodische Entwicklung von Scores am Beispiel des Diabetes. Diabetologe 10, 541–546 (2014). https://doi.org/10.1007/s11428-014-1210-z

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  • DOI: https://doi.org/10.1007/s11428-014-1210-z

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