Background /Aims To evaluate the performance of existing prediction models to determine risk of progression to referable diabetic retinopathy (RDR) using data from a prospective Irish cohort of people with type 2 diabetes (T2D). Methods A cohort of 939 people with T2D followed prospectively was used to test the performance of risk prediction models developed in Gloucester, UK, and Iceland. Observed risk of progression to RDR in the Irish cohort was compared with that derived from each of the prediction models evaluated. Receiver operating characteristic curves assessed models’ performance. Results The cohort was followed for a total of 2929 person years during which 2906 screening episodes occurred. Among 939 individuals followed, there were 40 referrals (4%) for diabetic maculopathy, pre-proliferative DR and proliferative DR. The original Gloucester model, which includes results of two consecutive retinal screenings; a model incorporating, in addition, systemic biomarkers (HbA1c and serum cholesterol); and a model including results of one retinopathy screening, HbA1c, total cholesterol and duration of diabetes, had acceptable discriminatory power (area under the curve (AUC) of 0.69, 0.76 and 0.77, respectively). The Icelandic model, which combined retinopathy grading, duration and type of diabetes, HbA1c and systolic blood pressure, performed very similarly (AUC of 0.74). Conclusion In an Irish cohort of people with T2D, the prediction models tested had an acceptable performance identifying those at risk of progression to RDR. These risk models would be useful in establishing more personalised screening intervals for people with T2D. Data are available on reasonable request to NL, The Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University, Belfast (orcid.org/0000-0003-2666-2937).

中文翻译：

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测试风险预测模型的性能以确定爱尔兰 2 型糖尿病队列中可参考的糖尿病视网膜病变的进展

背景/目的 使用来自前瞻性爱尔兰 2 型糖尿病 (T2D) 人群的数据评估现有预测模型的性能，以确定进展为可参考糖尿病视网膜病变 (RDR) 的风险。方法 使用前瞻性跟踪的 939 名 T2D 患者队列来测试在格洛斯特、英国和冰岛开发的风险预测模型的性能。将爱尔兰队列中观察到的进展为 RDR 的风险与来自每个评估的预测模型的风险进行比较。接收器操作特征曲线评估模型的性能。结果 该队列共跟踪了 2929 人年，在此期间发生了 2906 次筛查事件。在随访的 939 人中，有 40 人 (4%) 被转诊为糖尿病黄斑病变、增殖前 DR 和增殖性 DR。原始的 Gloucester 模型，包括两次连续视网膜检查的结果；此外，还包含全身生物标志物（HbA1c 和血清胆固醇）的模型；一个包括一项视网膜病变筛查结果、HbA1c、总胆固醇和糖尿病持续时间的模型具有可接受的区分能力（曲线下面积（AUC）分别为 0.69、0.76 和 0.77）。结合视网膜病变分级、糖尿病持续时间和类型、HbA1c 和收缩压的冰岛模型表现非常相似（AUC 为 0.74）。结论 在爱尔兰的 T2D 人群中，测试的预测模型在识别有进展为 RDR 风险的人方面具有可接受的性能。这些风险模型将有助于为 T2D 患者建立更个性化的筛查间隔。