Better Than Framingham: How Sound Are the Claims?

Investigators evaluate the strength of trial findings showing incremental value of risk markers for CHD beyond the FRS.

In the quest to “build a better mousetrap” for prediction of an individual's risk for cardiovascular events, multiple studies have addressed strategies to improve on the Framingham risk score (FRS). To determine the validity of such studies' findings, Tzoulaki and colleagues assessed the designs and analyses of 79 trials by comparing the predictive value of the FRS alone with the predictive value of the FRS plus one or more other risk markers.

Most authors had concluded that the markers they studied added to the predictive value of the FRS. However, the present authors identified substantial flaws in most of the trials. Of particular concern were the inappropriate use of statistical tools, potentially leading to overestimation of the propose…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)