What is the accuracy of CVD risk assessment?

Updated: Nov 30, 2018
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Answer

Issues of accuracy of risk calculations are not limited to the ACC/AHA-ASCVD risk estimator. All of the above scores have been validated and perform well in discriminating persons who will develop CVD from those who will not. However, the match between the prediction and actual outcome (score calibration) greatly varies when the algorithms are applied to populations with differing demographics than those of the cohort from which it was developed. [17]

Numerous studies reported calibration disparity in risk assessment using the scores above. For example, a 2015 study utilizing data from the Multi-Ethnic Study of Atherosclerosis (MESA), measured calibration for five risk scores and found the following overestimates for the risk of cardiovascular events [18] :

  • FRS-CHD: 53% in men, 48% in women
  • FRS-CVD: 37% in men, 8% in women
  • FRS-ATP-III: 154% in men, 46% in women
  • ACC/AHA-ASCVD: 86% in men, 67% in women

In this study, the RRS was the best calibrated model, with investigators reporting the lowest discordance between actual and predicted events (-3%). [18]


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