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Pearl Toh, 3 days ago
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Migraine and headache are common ailments of people living in the modern era. Dr Jon Marshall of The Singapore Headache and Migraine Clinic shares his insights with Pearl Toh on how to manage migraine and headache using non-pharmaceutical strategies, with a focus on the manual medicine approach.
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Novel prediction model detects progression to advanced AMD

18 Apr 2021

A comprehensive prediction model that applies a machine learning algorithm allowing selection of the most predictive risk factors automatically achieves high discrimination abilities in calculating progression to advanced age-related macular degeneration (AMD), as shown in two cohort studies.

This paves the way toward making precision medicine for AMD patients a reality in the near future, according to the investigators.

The Rotterdam Study I (RS-I; training set) included 3,838 participants aged 55 years, with a median follow-up of 10.8 years, and 108 incident cases of advanced AMD. In addition, the Antioxydants, Lipids Essentiels, Nutrition et Maladies Oculaires (ALIENOR) study (test set) included 362 individuals aged 73 years, with a median follow-up of 6.5 years, and 33 incident cases of advanced AMD.

The prediction model utilized the bootstrap least absolute shrinkage and selection operator (LASSO) method for survival analysis to select the best predictors of incident advanced AMD in the training set. The area under the receiver operating characteristic curve (AUC) was used to assess the predictive performance of the model.

The following factors were retained in the prediction model: age, a combination of phenotypic predictors (based on the presence of intermediate drusen, hyperpigmentation in one or both eyes, and Age-Related Eye Disease Study simplified score), a summary genetic risk score based on 49 single nucleotide polymorphisms, smoking, diet quality, education, and pulse pressure.

In RS-I, the cross-validated AUC estimation was 0.92 (95 percent confidence interval [CI], 0.88–0.97) at 5 years, 0.92 (95 percent CI, 0.90–0.95) at 10 years, and 0.91 (95 percent CI, 0.88–0.94) at 15 years. In ALIENOR, the AUC was 0.92 (95 percent CI, 0.87–0.98) at 5 years.

When it came to calibration, the model seemed to underestimate the cumulative incidence of advanced AMD for the high-risk groups, especially in ALIENOR.

“Current prediction models for advanced AMD are based on a restrictive set of risk factors,” the investigators noted.

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Most Read Articles
Pearl Toh, 3 days ago
Not only does the CGRP* inhibitor galcanezumab show sustained efficacy in migraine patients, long-term treatment does not come with excess cardiovascular (CV) risk, according to studies presented at the AAN 2021 Annual Meeting.
01 Apr 2021
Migraine and headache are common ailments of people living in the modern era. Dr Jon Marshall of The Singapore Headache and Migraine Clinic shares his insights with Pearl Toh on how to manage migraine and headache using non-pharmaceutical strategies, with a focus on the manual medicine approach.
Tristan Manalac, 4 days ago
Visceral fat area is the strongest indicator of mobility disability among obese, community-dwelling, older adults, according to a recent Singapore study.
3 days ago
In a webinar held on 27 March 2021, paediatric endocrinology nurses Karen Blair, Kate Davies, and Siti Zarina Yaakop shared insights and clinical experience based on their frontline roles in caring for patients with central precocious puberty (CPP) and supporting their family members.