Mixed
The RECODe risk equations provide more accurate predictions for microvascular and cardiovascular complications in diverse U.S. populations with type 2 diabetes compared to older models like UKPDS OM2 and ACC/AHA PCEs, which tend to substantially overestimate risk.
For clinicians managing diverse type 2 diabetes patients, using the RECODe risk equations instead of older models (like UKPDS or ACC/AHA PCEs) leads to more accurate risk assessment. This accuracy helps avoid unnecessary aggressive treatments for patients at lower actual risk and ensures high-risk patients receive appropriate intensive care, thereby reducing drug-related morbidity and improving overall population health management.
The RECODe equations improved upon prior risk equations for the prediction of key outcomes of interest among people with type 2 diabetes. The RECODe equations outperformed the UKPDS OM2 and ACC/AHA PCE risk equations based on metrics for discrimination and calibration, whereas the latter two risk equation sets exhibited substantial overprediction of both macrovascular and microvascular events in the studied cohorts.
Why this rating
Large sample sizes (n=1,555 MESA, n=1,746 JHS), rigorous adjudication of outcomes, and external validation in diverse cohorts.
Source
Validation of Risk Equations for Complications of Type 2 Diabetes (RECODe) Using Individual Participant Data From Diverse Longitudinal Cohorts in the U.S.
Sanjay Basu et al. · Diabetes Care · 2017
DOI 10.2337/dc17-2002
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