The Dizzying Array of Risk Models for Cardiovascular Disease

Risk models for cardiovascular disease (CVD) are so numerous that many doctors rightly wonder which ones they should use. Investigators in Europe conducted a systematic review of 363 published CVD risk models for the general population. They examined 125 articles about the development of the models and 136 articles with external validation of one or more models.

The models varied greatly in what they predicted (median number of variables, 7; range, 2–80) and in how they defined clinical outcomes. Sample sizes ranged from 51 to nearly 1.2 million; the number of observed events ranged from 28 to 55,667. Modeling methods and the models' presentations (e.g., calculator, risk chart, sum score, nomogram) also varied substantially.

Predictive perfor…