Key result
Time-anchored disease histories increased China-to-England cardiovascular model calibration slope by 0.367 (95% CI 0.053 to 0.594; P=0.008) vs released histories via cohort composition changes.
Why the study?
Harmonised disease histories can incorporate later reports, which may alter study eligibility, outcomes, and cardiovascular model transport.
Does reconstructing time-anchored disease histories (compared to released harmonised histories that incorporate later reports) alter baseline cardiovascular disease-free eligibility, outcome ascertainment, and reciprocal cardiovascular risk prediction model transport between cohorts of older adults in England and China?
Observational (n=14,611)
Yes
Does reconstructing time-anchored disease histories (compared to released harmonised histories that incorporate later reports) alter baseline cardiovascular disease-free eligibility, outcome ascertainment, and reciprocal cardiovascular risk prediction model transport between cohorts of older adults in England and China?
Incorporating diagnoses reported at later survey waves into earlier harmonised disease histories alters baseline cardiovascular disease-free cohort eligibility and outcome ascertainment, significantly affecting model calibration slopes during cross-national validation without genuinely improving predictive performance.
Background Harmonised disease histories can incorporate later reports, altering eligibility, outcomes, and model transport. Methods Reciprocal external validation compared released and time-anchored histories among CHARLS and ELSA participants aged 60 years or older. Analyses used full and common risk sets, prespecified sex interactions, multiple imputation, and 500 paired household bootstraps. Results Histories disagreed in 8.95% of CHARLS and 6.11% of ELSA participants; gross churn was 10.57% and 7.91%. Released and time-anchored calibration slopes were 0.173 (95% CI − 0.121 to 0.468) and 0.473 (0.189 to 0.758) for China-to-England transport, and 0.299 (0.002 to 0.596) and 0.478 (0.208 to 0.748) for England-to-China transport. AUC and Brier error both increased; IPA remained negative. Common-risk-set calibration-slope, AUC, and IPA estimates and all sex contrasts had confidence intervals spanning zero. England-to-China common-risk-set Brier error increased. Conclusions In harmonised cohorts, incorporating diagnoses reported at later waves into earlier disease histories changed cardiovascular disease-free eligibility and interval-specific outcome ascertainment among adults aged 60 years or older, and changed the calibration slope for China-to-England transport. The difference between full-pipeline and common-risk-set results indicated that this effect operated through cohort composition rather than predictor recoding and did not constitute an improvement in overall predictive performance.
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Liu et al. (2026) conducted an observational in Cardiovascular disease (n=14,611). Time-anchored disease history definition vs. Released harmonised disease history definition was evaluated on Calibration slope of reciprocal cardiovascular risk model transport (China-to-England) (MD 0.367, 95% CI 0.053 to 0.594, p=0.008). Time-anchored disease histories increased China-to-England cardiovascular model calibration slope by 0.367 (95% CI 0.053 to 0.594; P=0.008) vs released histories via cohort composition changes.
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