Development and Case-Control Validation of the Canadian Men’s Health Foundation’s Self Risk Assessment Tool:

Abstract

Background and Objective: To facilitate the engagement of men in evaluation of their own health status and risk of disease, we have developed and validated the Canadian Men’s Health Foundation’s self-risk assessment tool (“You Check”). In a single questionnaire, the “You Check” tool estimates the 10-year risk for myocardial infarction (MI), diabetes type 2 (DM), osteoporosis (OS), erectile dysfunction (ED), and low testosterone (LT). Additionally, the tool provides the user with his risk factor profile for prostate cancer and his current risk of depression (using the Center for Epidemiologic Studies Depression scale). Materials and Methods: Known risk factors for each disease were collated, the questionnaire designed, and risk scores for each disease were assigned by clinical experts. A risk formula was developed using the sum of risk scores divided by their own range. We validated the risk models with case-control data from a retrospective review of 400 outpatient records from four Vancouver family practice clinics. Maximal correct classification proportions were determined and used as thresholds for categorization of risk to low, medium, or high categories. Results: For DM, sensitivity and specificity were 0.86 and 0.96 respectively and AUC was 0.88 (95% Confidence Interval [CI] 0.81-0.94). For MI these values were 0.70 and 0.93, and 0.75 (0.65-0.85); for LT 0.70 and 0.90 and 0.75 (0.66-0.84); for OS 0.70 and 0.86 and 0.70 (0.61-0.80); and for ED 0.42 and 0.96 and 0.66 (0.58-0.75). Conclusion: This is the first comprehensive men’s health self-risk assessment tool for seven important diseases. Moderate internal validity was demonstrated for five diseases, meeting the public health objectives of “You Check” which is now in the public domain and under appropriate monitoring and evaluation (https://youcheck.ca).