Does adding information on job strain improve risk prediction for coronary heart disease beyond the standard Framingham risk score? The Whitehall II study
Key result
Adding job strain to the Framingham risk score did not improve predictive performance for CHD mortality and non-fatal MI (net reclassification improvement 0.7%; 95% CI -4.2 to 5.6%).
Why the study?
Does adding information on job strain to the Framingham risk score improve risk prediction for coronary heart disease in a low-risk working population?
Population
5,533 adults from the prospective Whitehall II cohort study, UK, who were CHD free at baseline.
Comparison
Risk prediction using Framingham risk score plus… vs Risk prediction using standard Framingham risk…
Design
Cohort
Follow-up
mean 11.3 years
Authors
Discussion
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Member takes
Implication
Does not support adding job strain to Framingham CHD risk prediction in low-risk workers; leaves open its value in higher-risk groups or with updated scores.
Study Design
Type
Cohort (n=5,533)
Structured PICO
Does adding information on job strain to the Framingham risk score improve risk prediction for coronary heart disease in a low-risk working population?
P
Population
5,533 adults (mean age 48.9 years, 30.1% female) free of CHD at baseline, followed for a mean of 11.3 years.
E
Exposure
Risk prediction using Framingham risk score plus job strain indicators
C
Comparator
Risk prediction using standard Framingham risk score
O
Outcome
Composite of CHD mortality and non-fatal myocardial infarction (MI)composite
Main Result
Effect estimate: Net reclassification improvement 0.7% (95% CI -4.2 to 5.6)
Adding job strain to the Framingham risk score does not meaningfully improve coronary heart disease risk prediction in a low-risk working population.
Cite This Study
Kivimäki et al. (2011) conducted a cohort in Coronary heart disease (n=5,533). Job strain vs. Framingham risk score alone was evaluated on CHD mortality and non-fatal myocardial infarction (MI) (Net reclassification improvement 0.7%, 95% CI -4.2 to 5.6). Adding job strain to the Framingham risk score did not improve predictive performance for CHD mortality and non-fatal MI (net reclassification improvement 0.7%; 95% CI -4.2 to 5.6%).