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Primary prevention focuses on ensuring that healthy people remain healthy. As it is practically difficult to provide intervention for an entire healthy population, it is essential to identify and target the  at risk of risks  population. We aimed to distinguish  at risk of risks  population using data envelopment analysis (DEA). Efficiency score was calculated from the DEA using a cohort sample and its association with the onset of hypertension and dyslipidemia was analyzed. A stratification analysis was performed according to the number of conventional risk factors in participants. The adjusted odds ratios (aORs) of the incidence of hypertension and dyslipidemia according to a 0.1-point increase in efficiency score were 0.66 (90% confidence interval [CI] 0.55–0.78, p < 0.0001) and 0.84 (90% CI 0.75–0.94, p = 0.01), respectively. In the stratification analysis, aOR of the incidence of hypertension according to a 0.1-point increase in efficiency score was 0.57 (90% CI 0.37–0.89, p = 0.04) in participants with no conventional risk factors. Participants with lower efficiency score were suggested to be at high risk for future onset of hypertension and dyslipidemia. The DEA might enable us to identify the risk of hypertension where conventional methods might fail.

Efficiency score from data envelopment analysis can predict the future onset of hypertension and dyslipidemia: A cohort study