UKPDS risk engine

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The UKPDS risk engine is a type 2 diabetes-specific cardiovascular disease and stroke risk calculator based on 53,000 patients years of data from the UK Prospective Diabetes Study (UKPDS).

The risk engine generates risk estimates and 95% confidence intervals, in individuals with type 2 diabetes not known to have heart disease, for:

  • non-fatal and fatal coronary heart disease
  • fatal coronary heart disease
  • non-fatal and fatal stroke
  • fatal stroke

Risk estimates can be calculated for any given duration of type 2 diabetes based on:

  • current age
  • sex
  • ethnicity
  • smoking status
  • presence or absence of atrial fibrillation
  • levels of HbA1c
  • systolic blood pressure
  • total cholesterol
  • HDL cholesterol

Type 2 diabetes patient specificity

The UKPDS risk engine is specific for people with type 2 diabetes, for whom general population risk calculators are inaccurate. For example, risk calculators based on equations from the Framingham Heart Study tend to underestimate disease risks of people with diabetes, as the study population included relatively few diabetic subjects.

The science behind the software

The UKPDS risk engine utilises data collected from over 5,000 patients enrolled in the 30 year UKPDS – the largest and longest study of its kind, which has provided a unique opportunity to develop a type 2 diabetes-specific risk calculator.

Advantages of the UKPDS risk engine are:

  • ability to estimate risk in people with pre-existing diabetes, as well as those newly-diagnosed

  • provides ‘cardiovascular disease’ as the primary output, consistent with revised NICE guidance

  • ability to estimate risk in people with previous cardiovascular events, as well as those with no prior history of cardiovascular disease

  • ability to incorporate additional risk factors to enhance predictive accuracy

  • intuitive and streamlined user interface

Other uses of the UKPDS risk engine

The excel spreadsheet-enabled version of the risk engine can be used to estimate future risks for large numbers of individuals to inform sample size estimations for clinical trials and to inform health care planning.

The risk engine application programming interface (API) can be incorporated into other software to automatically provide risk estimates when the requisite date are available eg general practice or hospital outpatient computer systems.

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