Key result
Cardiovascular risk categorization using country-of-residence versus country-of-birth algorithms showed disparities among migrants, with differences in high-risk categorization ranging from 0% to 13%.
Why the study?
It is unclear whether migrants' country-of-residence or country-of-birth algorithms agree in stratifying CVD risk.
Do country-of-residence-specific CVD risk scores agree with country-of-birth-specific scores in stratifying risk among ethnic minority migrants?
Observational
Do country-of-residence-specific CVD risk scores agree with country-of-birth-specific scores in stratifying risk among ethnic minority migrants?
There are significant disparities in CVD risk categorization when using country-of-residence versus country-of-birth risk algorithms for ethnic minorities, highlighting the need for further validation.
Algorithms may disagree on migrant CVD risk stratification; leaves open which score better predicts events in Dutch ethnic minorities.
BACKGROUND: Regional and country-specific cardiovascular risk algorithms have been developed to improve CVD risk prediction. But it is unclear whether migrants' country-of-residence or country-of-birth algorithms agree in stratifying the CVD risk of these populations. We evaluated the risk stratification by the different algorithms, by comparing migrant country-of-residence-specific scores to migrant country-of-birth-specific scores for ethnic minority populations in the Netherlands. METHOD: data from the HELIUS study was used in estimating the CVD risk scores for participants using five laboratory-based (Framingham, Globorisk, Pool Cohort Equation II, SCORE II, and WHO II) and three nonlaboratory-based (Framingham, Globorisk, and WHO II) risk scores with the risk chart for the Netherlands. For the Globorisk, WHO II, and SCORE II risk scores, we also computed the risk scores using risk charts specified for the migrant home country. Risk categorization was first done according to the specification of the risk algorithm and then simplified to low (green), moderate (yellow and orange), and high risk (red). RESULTS: we observed differences in risk categorization for different risk algorithms ranging from 0% (Globorisk) to 13% (Framingham) for the high-risk category, as well as differences in the country-of-residence- and country-of-birth-specific scores. Agreement between different scores ranged from none to moderate. We observed a moderate agreement between the Netherlands-specific SCORE II and the country-of-birth SCORE II for the Turkish and a nonagreement for the Dutch Moroccan population. CONCLUSION: disparities exist in the use of the country-of-residence-specific, as compared to the country-of-birth, risk algorithms among ethnic minorities living in the Netherlands. Hence, there is a need for further validation of country-of-residence- and country-of-birth-adjusted scores to ascertain appropriateness and reliability.
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Osei-Yeboah et al. (2023) conducted an observational in Cardiovascular risk. Country-of-residence-specific cardiovascular risk algorithms vs. Country-of-birth-specific cardiovascular risk algorithms was evaluated on Risk categorization and agreement between different risk algorithms. Cardiovascular risk categorization using country-of-residence versus country-of-birth algorithms showed disparities among migrants, with differences in high-risk categorization ranging from 0% to 13%.
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