A Validated Prediction Model for End-Stage Kidney Disease in Type 1 Diabetes. Diabetes Care 2021;44:901-907.

We would like to thank Ostergaard et al. (1) for their perspective on our article (2), which includes a suggestion for using lifetime prediction models to estimate disease-free life expectancy. The lifetime prediction models previously published are primarily based on Cox proportional hazards models including age as timescale (3). We have used Poisson models that facilitate the inclusion of multiple timescales such as age and diabetes duration. Both modeling approaches estimate a hazard function for the event of interest as well as for the competing event of death, and with both approaches these hazard functions can be used to estimate lifetime risk and disease-free life expectancy. As pointed out by Ostergaard et al., risk prediction should ideally cover a long time horizon, and in that sense estimating lifetime risk may seem attractive. Models predicting diseases …