Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study

Wing Tse; Golam M. Khandaker; Huiquan Zhou; Hao Luo; Wai Ching Yan; Man Wah Siu; Lap Tak Poon; Edwin Ho Ming Lee; Qingpeng Zhang; Rachel Upthegrove; Emanuele F. Osimo; Benjamin I. Perry; Sherry Kit Wa Chan

doi:10.1016/j.lanwpc.2024.101089

Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study

Wing Tse
, Golam M. Khandaker
, Huiquan Zhou
, Hao Luo
, Wai Ching Yan
, Man Wah Siu
, Lap Tak Poon
, Edwin Ho Ming Lee
, Qingpeng Zhang
, Rachel Upthegrove
, Emanuele F. Osimo
, Benjamin I. Perry^*
, Sherry Kit Wa Chan^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

34 Downloads (Pure)

Abstract

Background: Metabolic syndrome (MetS) is common following first-episode psychosis (FEP), contributing to substantial morbidity and mortality. The Psychosis Metabolic Risk Calculator (PsyMetRiC), a risk prediction algorithm for MetS following a FEP diagnosis, was developed in the United Kingdom and has been validated in other European populations. However, the predictive accuracy of PsyMetRiC in Chinese populations is unknown.

Methods: FEP patients aged 15–35 y, first presented to the Early Assessment Service for Young People with Early Psychosis (EASY) Programme in Hong Kong (HK) between 2012 and 2021 were included. A binary MetS outcome was determined based on the latest available follow-up clinical information between 1 and 12 years after baseline assessment. The PsyMetRiC Full and Partial algorithms were assessed for discrimination, calibration and clinical utility in the HK sample, and logistic calibration was conducted to account for population differences. Sensitivity analysis was performed in patients aged >35 years and using Chinese MetS criteria.

Findings: The main analysis included 416 FEP patients (mean age = 23.8 y, male sex = 40.4%, 22.4% MetS prevalence at follow-up). PsyMetRiC showed adequate discriminative performance (full-model C = 0.76, 95% C.I. = 0.69–0.81; partial-model: C = 0.73, 95% C.I. = 0.65–0.8). Systematic risk underestimation in both models was corrected using logistic calibration to refine PsyMetRiC for HK Chinese FEP population (PsyMetRiC-HK). PsyMetRiC-HK provided a greater net benefit than competing strategies. Results remained robust with a Chinese MetS definition, but worse for the older age group.

Interpretation: With good predictive performance for incident MetS, PsyMetRiC-HK presents a step forward for personalized preventative strategies of cardiometabolic morbidity and mortality in young Hong Kong Chinese FEP patients.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Original language	English
Article number	101089
Number of pages	11
Journal	The Lancet Regional Health - Western Pacific
Volume	47
Early online date	14 May 2024
DOIs	https://doi.org/10.1016/j.lanwpc.2024.101089
Publication status	Published - Jun 2024

Bibliographical note

Publisher Copyright:
© 2024 The Author(s)

Keywords

First-episode psychosis
Metabolic syndrome
Net benefit
Prediction risk calculator

ASJC Scopus subject areas

Internal Medicine
Pediatrics, Perinatology, and Child Health
Health Policy
Obstetrics and Gynaecology
Public Health, Environmental and Occupational Health
Geriatrics and Gerontology
Psychiatry and Mental health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Tse, W., Khandaker, G. M., Zhou, H., Luo, H., Yan, W. C., Siu, M. W., Poon, L. T., Lee, E. H. M., Zhang, Q., Upthegrove, R., Osimo, E. F., Perry, B. I., & Chan, S. K. W. (2024). Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study. The Lancet Regional Health - Western Pacific, 47, Article 101089. https://doi.org/10.1016/j.lanwpc.2024.101089

@article{0ed2481109b24b969a67599eaaa54fec,

title = "Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study",

abstract = "Background: Metabolic syndrome (MetS) is common following first-episode psychosis (FEP), contributing to substantial morbidity and mortality. The Psychosis Metabolic Risk Calculator (PsyMetRiC), a risk prediction algorithm for MetS following a FEP diagnosis, was developed in the United Kingdom and has been validated in other European populations. However, the predictive accuracy of PsyMetRiC in Chinese populations is unknown. Methods: FEP patients aged 15–35 y, first presented to the Early Assessment Service for Young People with Early Psychosis (EASY) Programme in Hong Kong (HK) between 2012 and 2021 were included. A binary MetS outcome was determined based on the latest available follow-up clinical information between 1 and 12 years after baseline assessment. The PsyMetRiC Full and Partial algorithms were assessed for discrimination, calibration and clinical utility in the HK sample, and logistic calibration was conducted to account for population differences. Sensitivity analysis was performed in patients aged >35 years and using Chinese MetS criteria. Findings: The main analysis included 416 FEP patients (mean age = 23.8 y, male sex = 40.4\%, 22.4\% MetS prevalence at follow-up). PsyMetRiC showed adequate discriminative performance (full-model C = 0.76, 95\% C.I. = 0.69–0.81; partial-model: C = 0.73, 95\% C.I. = 0.65–0.8). Systematic risk underestimation in both models was corrected using logistic calibration to refine PsyMetRiC for HK Chinese FEP population (PsyMetRiC-HK). PsyMetRiC-HK provided a greater net benefit than competing strategies. Results remained robust with a Chinese MetS definition, but worse for the older age group. Interpretation: With good predictive performance for incident MetS, PsyMetRiC-HK presents a step forward for personalized preventative strategies of cardiometabolic morbidity and mortality in young Hong Kong Chinese FEP patients. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.",

keywords = "First-episode psychosis, Metabolic syndrome, Net benefit, Prediction risk calculator",

author = "Wing Tse and Khandaker, \{Golam M.\} and Huiquan Zhou and Hao Luo and Yan, \{Wai Ching\} and Siu, \{Man Wah\} and Poon, \{Lap Tak\} and Lee, \{Edwin Ho Ming\} and Qingpeng Zhang and Rachel Upthegrove and Osimo, \{Emanuele F.\} and Perry, \{Benjamin I.\} and Chan, \{Sherry Kit Wa\}",

note = "Publisher Copyright: {\textcopyright} 2024 The Author(s)",

year = "2024",

month = jun,

doi = "10.1016/j.lanwpc.2024.101089",

language = "English",

volume = "47",

journal = "The Lancet Regional Health - Western Pacific",

issn = "2666-6065",

publisher = "Elsevier Korea",

}

Tse, W, Khandaker, GM, Zhou, H, Luo, H, Yan, WC, Siu, MW, Poon, LT, Lee, EHM, Zhang, Q, Upthegrove, R, Osimo, EF, Perry, BI & Chan, SKW 2024, 'Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study', The Lancet Regional Health - Western Pacific, vol. 47, 101089. https://doi.org/10.1016/j.lanwpc.2024.101089

Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study. / Tse, Wing; Khandaker, Golam M.; Zhou, Huiquan et al.
In: The Lancet Regional Health - Western Pacific, Vol. 47, 101089, 06.2024.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population

T2 - a 4-year follow-up study

AU - Tse, Wing

AU - Khandaker, Golam M.

AU - Zhou, Huiquan

AU - Luo, Hao

AU - Yan, Wai Ching

AU - Siu, Man Wah

AU - Poon, Lap Tak

AU - Lee, Edwin Ho Ming

AU - Zhang, Qingpeng

AU - Upthegrove, Rachel

AU - Osimo, Emanuele F.

AU - Perry, Benjamin I.

AU - Chan, Sherry Kit Wa

PY - 2024/6

Y1 - 2024/6

N2 - Background: Metabolic syndrome (MetS) is common following first-episode psychosis (FEP), contributing to substantial morbidity and mortality. The Psychosis Metabolic Risk Calculator (PsyMetRiC), a risk prediction algorithm for MetS following a FEP diagnosis, was developed in the United Kingdom and has been validated in other European populations. However, the predictive accuracy of PsyMetRiC in Chinese populations is unknown. Methods: FEP patients aged 15–35 y, first presented to the Early Assessment Service for Young People with Early Psychosis (EASY) Programme in Hong Kong (HK) between 2012 and 2021 were included. A binary MetS outcome was determined based on the latest available follow-up clinical information between 1 and 12 years after baseline assessment. The PsyMetRiC Full and Partial algorithms were assessed for discrimination, calibration and clinical utility in the HK sample, and logistic calibration was conducted to account for population differences. Sensitivity analysis was performed in patients aged >35 years and using Chinese MetS criteria. Findings: The main analysis included 416 FEP patients (mean age = 23.8 y, male sex = 40.4%, 22.4% MetS prevalence at follow-up). PsyMetRiC showed adequate discriminative performance (full-model C = 0.76, 95% C.I. = 0.69–0.81; partial-model: C = 0.73, 95% C.I. = 0.65–0.8). Systematic risk underestimation in both models was corrected using logistic calibration to refine PsyMetRiC for HK Chinese FEP population (PsyMetRiC-HK). PsyMetRiC-HK provided a greater net benefit than competing strategies. Results remained robust with a Chinese MetS definition, but worse for the older age group. Interpretation: With good predictive performance for incident MetS, PsyMetRiC-HK presents a step forward for personalized preventative strategies of cardiometabolic morbidity and mortality in young Hong Kong Chinese FEP patients. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

AB - Background: Metabolic syndrome (MetS) is common following first-episode psychosis (FEP), contributing to substantial morbidity and mortality. The Psychosis Metabolic Risk Calculator (PsyMetRiC), a risk prediction algorithm for MetS following a FEP diagnosis, was developed in the United Kingdom and has been validated in other European populations. However, the predictive accuracy of PsyMetRiC in Chinese populations is unknown. Methods: FEP patients aged 15–35 y, first presented to the Early Assessment Service for Young People with Early Psychosis (EASY) Programme in Hong Kong (HK) between 2012 and 2021 were included. A binary MetS outcome was determined based on the latest available follow-up clinical information between 1 and 12 years after baseline assessment. The PsyMetRiC Full and Partial algorithms were assessed for discrimination, calibration and clinical utility in the HK sample, and logistic calibration was conducted to account for population differences. Sensitivity analysis was performed in patients aged >35 years and using Chinese MetS criteria. Findings: The main analysis included 416 FEP patients (mean age = 23.8 y, male sex = 40.4%, 22.4% MetS prevalence at follow-up). PsyMetRiC showed adequate discriminative performance (full-model C = 0.76, 95% C.I. = 0.69–0.81; partial-model: C = 0.73, 95% C.I. = 0.65–0.8). Systematic risk underestimation in both models was corrected using logistic calibration to refine PsyMetRiC for HK Chinese FEP population (PsyMetRiC-HK). PsyMetRiC-HK provided a greater net benefit than competing strategies. Results remained robust with a Chinese MetS definition, but worse for the older age group. Interpretation: With good predictive performance for incident MetS, PsyMetRiC-HK presents a step forward for personalized preventative strategies of cardiometabolic morbidity and mortality in young Hong Kong Chinese FEP patients. Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

KW - First-episode psychosis

KW - Metabolic syndrome

KW - Net benefit

KW - Prediction risk calculator

UR - https://www.scopus.com/pages/publications/85193025286

U2 - 10.1016/j.lanwpc.2024.101089

DO - 10.1016/j.lanwpc.2024.101089

M3 - Article

AN - SCOPUS:85193025286

SN - 2666-6065

VL - 47

JO - The Lancet Regional Health - Western Pacific

JF - The Lancet Regional Health - Western Pacific

M1 - 101089

ER -

Tse W, Khandaker GM, Zhou H, Luo H, Yan WC, Siu MW et al. Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study. The Lancet Regional Health - Western Pacific. 2024 Jun;47:101089. Epub 2024 May 14. doi: 10.1016/j.lanwpc.2024.101089