BACKGROUND This systematic review aimed to investigate the current state of risk prediction for abdominal aortic aneurysm in the literature, identifying and comparing published models and describing their performance and applicability to a population-based targeted screening strategy. METHODS Electronic databases MEDLINE (via Ovid), Embase (via Ovid), MedRxiv, Web of Science, and the Cochrane Library were searched for papers reporting or validating risk prediction models for abdominal aortic aneurysm. Studies were included only if they were developed on a cohort or study group derived from the general population and used multiple variables with at least one modifiable risk factor. Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool. A synthesis and comparison of the identified models was undertaken. RESULTS The search identified 4813 articles. After full-text review, 37 prediction models were identified, of which 4 were unique predictive models that were reported in full. Applicability was poor when considering targeted screening strategies using electronic health record-based populations. Common risk factors used for the predictive models were explored across all 37 models; the most common risk factors in predictive models for abdominal aortic aneurysm were: age, sex, biometrics (such as height, weight, or BMI), smoking, hypertension, hypercholesterolaemia, and history of heart disease. Few models had undergone standardized model development, adequate external validation, or impact evaluation. CONCLUSION This study identified four risk models that can be replicated and used to predict abdominal aortic aneurysm with acceptable levels of discrimination. None of the models have been validated externally.

中文翻译：

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以危险因素为目标的腹主动脉瘤筛查：腹主动脉瘤风险预测的系统评价。


背景本系统综述旨在调查文献中腹主动脉瘤风险预测的现状，识别和比较已发表的模型，并描述其性能和对基于人群的针对性筛查策略的适用性。方法 搜索电子数据库 MEDLINE（通过 Ovid）、Embase（通过 Ovid）、MedRxiv、Web of Science 和 Cochrane 图书馆，寻找报告或验证腹主动脉瘤风险预测模型的论文。仅当研究是在来自一般人群的队列或研究组中开发并使用具有至少一个可改变风险因素的多个变量时才纳入研究。使用预测模型偏倚风险评估工具评估偏倚风险。对已确定的模型进行了综合和比较。结果 搜索找到了 4813 篇文章。经过全文审查，确定了 37 个预测模型，其中 4 个是完整报告的独特预测模型。当考虑使用基于电子健康记录的人群的有针对性的筛查策略时，适用性很差。在所有 37 个模型中探索了用于预测模型的常见风险因素；腹主动脉瘤预测模型中最常见的危险因素是：年龄、性别、生物特征（例如身高、体重或BMI）、吸烟、高血压、高胆固醇血症和心脏病史。很少有模型经过标准化模型开发、充分的外部验证或影响评估。结论 这项研究确定了四种可以复制并用于预测腹主动脉瘤的风险模型，并且具有可接受的区分度。所有模型均未经过外部验证。