Assessing the incremental role of novel and emerging risk factors.
Open accessAbstract
Many novel and emerging risk factors exhibit a significant association with cardiovascular disease, but have not been found to improve risk prediction. Statistical criteria used to evaluate such models and markers have largely relied on the receiver operating characteristic curve, which is an insensitive measure of improvement. Recently, new methods have been developed based on risk reclassification, or changes in risk strata following use of a new marker or model. Associated measures based on both calibration and discrimination have been proposed. This review describes previous methods used to evaluate models as well as the newly developed methods to evaluate clinical utility.
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Only biomarkers that substantially improve the accuracy of the Framingham Index are likely to be adopted.
“Only biomarkers that substantially improve the accuracy of the Index are likely to be adopted whether they are based on genetics, proteomics, biochemistry, biometrics (e.g., blood pressure), or patient behaviors (53).”
From HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group (2012) · cites this paper as [53]
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- Authors
- Cook, N. R.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Cook, Nancy R.
- ORCID
- Cook, Nancy R.
- Venue
- Current Cardiovascular Risk Reports
- Published
- 2010-02-23
- Volume
- 4
- Issue
- 2
- Pages
- 112-119
- ISSN
- 1932-9520 (ISSN-L)
- 1932-9563
- PMC
- PMC2904250
- OpenAlex
- W2086966310
- Cited by
- 39
- References
- 50
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 6 · 2014: 4 · 2013: 5 · 2012: 8
- FWCI
- 4.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Cardiovascular Risk Reports (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Donald W. Reynolds Foundation
- National Institutes of Health (5r01hl043851-10)
- National Heart, Lung, and Blood Institute (R01‐HL043851)
- National Cancer Institute (R01CA047988)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- cardiovascular risk factors, cardiovascular disease, risk prediction model, risk reclassification, receiver operating characteristic, calibration, discrimination (statistics), clinical utility, novel biomarkers
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