Abstract 640: BMI as Surrogate for Cholesterol to Calculate Coronary Risk and to Decide on Lipid Lowering Medication: Improved Results with Carotid Total Plaque Area.
Bibliographic record
Abstract
Background: The Framingham risk calculator (FRAM) offers the possibility to use the body-mass-index (FRAMb) instead of total and HDL cholesterol (FRAMc). TPA, total plaque area of carotid arteries, may additionally serve to correct for inaccuracies due to unknown cholesterol measurements (FRAMb-TPA;FRAMc-TPA). Material and Methods: Participants were recruited from a free checkup program offered by the Swiss Vascular Risk Foundation and included healthy subjects aged > 45 years from the ongoing Cordicare II Study. Predictive risk was compared using the FRAM, FRAMb-TPA and FRAMc-TPA using linear regression models, kappa statistics and areas under the curve analysis (ROC). Results: Of 1,000 participants, 47% were females, mean age 60±9 years. 3.3% had Diabetes Mellitus type II, 11% were smokers, and 18% had family history of premature coronary disease. Mean systolic blood pressure was 134±15 mmHg and total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were 5.7±1.1, 1.6±0.4, and 3.5±0.9 and 1.4±0.7 mmol/l respectively. Mean body mass index was 26±4 kg/m2 and total plaque area was 51±51 mm2. Linear regression between FRAMc and FRAMb ten-year coronary risk showed an R2 = 0.89 (p<0.0001) and a Kappa coefficient of 0.72 (p<0.0001). This correlation was further enhanced when comparing FRAMc-TPA to FRAMb-TPA (R2 = 0.94, p<0.0001, wKappa 0.85, p 20% was assessed by ROC analysis and showed an area under the curve (AUC) of 0.98 (95% CI = 0.98 - 0.99, p<0.0001). FRAMb-TPA showing a risk of > 10% had a sensitivity and specificity of 92% and 56% (accuracy 75%) with the highest Youden’s Index, respectively, for the indication to lower LDL cholesterol according to the NCEP III guidelines and a risk assessment defined by FRAMc+TPA. Conclusion: When using the FRAM coronary risk function that uses BMI instead of total and HDL cholesterol and results from carotid plaque imaging, we observed a very high correlation, agreement and accuracy of this new method. Within this diagnostic setting, cholesterol profiles can be replaced by BMI without a relevant loss in coronary risk stratification. The indication for a lipid lowering medication defined by FRAMb-TPA is highly sensitive and moderately specific for a coronary risk cutoff of 10% or more.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".