Purchase this article with an account.
C.-J. Chiu, R. C. Milton, G. Gensler, A. Taylor; A Clinical Scoring System for the Early Prediction of Advanced Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2788.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Currently the few methods available for the prediction of advanced age-related macular degeneration (AMD) have limited accuracy and practicability because they did not use enough information or used predictors which are not readily available in clinics. The purpose of this study is to predict the occurrence of advanced AMD by summarizing established clinical risk factors.
Using 8177 eligible eyes from 4507 Age-Related Eye Disease Study (AREDS) participants as the training sample, we modeled the likelihood of developing advanced AMD (neovascularization or central geographic atrophy in 1185 eyes) during the 8 years of AREDS follow-up period in terms of 10 clinical risk factors which can be collected by trained clinical professionals.
A composite score (C score) for a tested eye can be calculated by summing an offset score (-5.02) and predictor scores (Cj) for those positive predictor attributes (C score = -5.02 + ΣCj , j=1 ~ n positive attributes). By choosing an adequate cut point for the C score, one can predict the occurrence of advanced AMD at a desired level of sensitivity and specificity. For example, when zero is set as the C score cut point (i.e. one can predict that an eye will develop advanced AMD in 8 years if its C score is larger than zero), the sensitivity and specificity are 83.3% and 76.2, respectively. We draw the receiver operating characteristic (ROC) curve by plotting sensitivities vs. 1-specificities at various C score cut points. The area under the ROC curve for this model is 0.88 suggesting excellent accuracy.
This composite scoring system would allow clinicians to identify individuals who are at high risk of developing advanced AMD and help them take preventive measures or make treatment plans. To assess this AMD prediction system, further validation studies in other populations are warranted.
Clinical Trial: :
This PDF is available to Subscribers Only