Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP)
BACKGROUND: Recurrent venous thromboembolism (VTE) is common. Current guidelines suggest that patients with unprovoked VTE should continue anticoagulants unless they have a high bleeding risk, whereas all others can stop. Prediction models may refine this dichotomous distinction, but existing models...
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Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788686/ http://www.ncbi.nlm.nih.gov/pubmed/31603898 https://doi.org/10.1371/journal.pmed.1002883 |
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ftpubmed:oai:pubmedcentral.nih.gov:6788686 2023-05-15T18:34:32+02:00 Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP) Timp, Jasmijn F. Braekkan, Sigrid K. Lijfering, Willem M. van Hylckama Vlieg, Astrid Hansen, John-Bjarne Rosendaal, Frits R. le Cessie, Saskia Cannegieter, Suzanne C. 2019-10-11 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788686/ http://www.ncbi.nlm.nih.gov/pubmed/31603898 https://doi.org/10.1371/journal.pmed.1002883 en eng Public Library of Science http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788686/ http://www.ncbi.nlm.nih.gov/pubmed/31603898 http://dx.doi.org/10.1371/journal.pmed.1002883 © 2019 Timp et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. CC-BY Research Article Text 2019 ftpubmed https://doi.org/10.1371/journal.pmed.1002883 2019-10-27T00:18:34Z BACKGROUND: Recurrent venous thromboembolism (VTE) is common. Current guidelines suggest that patients with unprovoked VTE should continue anticoagulants unless they have a high bleeding risk, whereas all others can stop. Prediction models may refine this dichotomous distinction, but existing models apply only to patients with unprovoked first thrombosis. We aimed to develop a prediction model for all patients with first VTE, either provoked or unprovoked. METHODS AND FINDINGS: Data were used from two population-based cohorts of patients with first VTE from the Netherlands (Multiple Environment and Genetic Assessment of Risk Factors for Venous Thrombosis [MEGA] follow-up study, performed from 1994 to 2009; model derivation; n = 3,750) and from Norway (Tromsø study, performed from 1999 to 2016; model validation; n = 663). Four versions of a VTE prediction model were developed: model A (clinical, laboratory, and genetic variables), model B (clinical variables and fewer laboratory markers), model C (clinical and genetic factors), and model D (clinical variables only). The outcome measure was recurrent VTE. To determine the discriminatory power, Harrell’s C-statistic was calculated. A prognostic score was assessed for each patient. Kaplan-Meier plots for the observed recurrence risks were created in quintiles of the prognostic scores. For each patient, the 2-year predicted recurrence risk was calculated. Models C and D were validated in the Tromsø study. During 19,201 person-years of follow-up (median duration 5.7 years) in the MEGA study, 507 recurrences occurred. Model A had the highest predictive capability, with a C-statistic of 0.73 (95% CI 0.71–0.76). The discriminative performance was somewhat lower in the other models, with C-statistics of 0.72 for model B, 0.70 for model C, and 0.69 for model D. Internal validation showed a minimal degree of optimism bias. Models C and D were externally validated, with C-statistics of 0.64 (95% CI 0.62–0.66) and 0.65 (95% CI 0.63–0.66), respectively. According to model C, ... Text Tromsø PubMed Central (PMC) Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) Norway Tromsø PLOS Medicine 16 10 e1002883 |
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Research Article Timp, Jasmijn F. Braekkan, Sigrid K. Lijfering, Willem M. van Hylckama Vlieg, Astrid Hansen, John-Bjarne Rosendaal, Frits R. le Cessie, Saskia Cannegieter, Suzanne C. Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP) |
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Research Article |
description |
BACKGROUND: Recurrent venous thromboembolism (VTE) is common. Current guidelines suggest that patients with unprovoked VTE should continue anticoagulants unless they have a high bleeding risk, whereas all others can stop. Prediction models may refine this dichotomous distinction, but existing models apply only to patients with unprovoked first thrombosis. We aimed to develop a prediction model for all patients with first VTE, either provoked or unprovoked. METHODS AND FINDINGS: Data were used from two population-based cohorts of patients with first VTE from the Netherlands (Multiple Environment and Genetic Assessment of Risk Factors for Venous Thrombosis [MEGA] follow-up study, performed from 1994 to 2009; model derivation; n = 3,750) and from Norway (Tromsø study, performed from 1999 to 2016; model validation; n = 663). Four versions of a VTE prediction model were developed: model A (clinical, laboratory, and genetic variables), model B (clinical variables and fewer laboratory markers), model C (clinical and genetic factors), and model D (clinical variables only). The outcome measure was recurrent VTE. To determine the discriminatory power, Harrell’s C-statistic was calculated. A prognostic score was assessed for each patient. Kaplan-Meier plots for the observed recurrence risks were created in quintiles of the prognostic scores. For each patient, the 2-year predicted recurrence risk was calculated. Models C and D were validated in the Tromsø study. During 19,201 person-years of follow-up (median duration 5.7 years) in the MEGA study, 507 recurrences occurred. Model A had the highest predictive capability, with a C-statistic of 0.73 (95% CI 0.71–0.76). The discriminative performance was somewhat lower in the other models, with C-statistics of 0.72 for model B, 0.70 for model C, and 0.69 for model D. Internal validation showed a minimal degree of optimism bias. Models C and D were externally validated, with C-statistics of 0.64 (95% CI 0.62–0.66) and 0.65 (95% CI 0.63–0.66), respectively. According to model C, ... |
format |
Text |
author |
Timp, Jasmijn F. Braekkan, Sigrid K. Lijfering, Willem M. van Hylckama Vlieg, Astrid Hansen, John-Bjarne Rosendaal, Frits R. le Cessie, Saskia Cannegieter, Suzanne C. |
author_facet |
Timp, Jasmijn F. Braekkan, Sigrid K. Lijfering, Willem M. van Hylckama Vlieg, Astrid Hansen, John-Bjarne Rosendaal, Frits R. le Cessie, Saskia Cannegieter, Suzanne C. |
author_sort |
Timp, Jasmijn F. |
title |
Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP) |
title_short |
Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP) |
title_full |
Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP) |
title_fullStr |
Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP) |
title_full_unstemmed |
Prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: The Leiden Thrombosis Recurrence Risk Prediction model (L-TRRiP) |
title_sort |
prediction of recurrent venous thrombosis in all patients with a first venous thrombotic event: the leiden thrombosis recurrence risk prediction model (l-trrip) |
publisher |
Public Library of Science |
publishDate |
2019 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788686/ http://www.ncbi.nlm.nih.gov/pubmed/31603898 https://doi.org/10.1371/journal.pmed.1002883 |
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ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
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Meier Norway Tromsø |
geographic_facet |
Meier Norway Tromsø |
genre |
Tromsø |
genre_facet |
Tromsø |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6788686/ http://www.ncbi.nlm.nih.gov/pubmed/31603898 http://dx.doi.org/10.1371/journal.pmed.1002883 |
op_rights |
© 2019 Timp et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
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CC-BY |
op_doi |
https://doi.org/10.1371/journal.pmed.1002883 |
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PLOS Medicine |
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