To the Editor: In their Commentary, Drs Hingorani and Psaty1 invoked the prevention paradox (a large proportion of cardiovascular disease [CVD] events occur among the many individuals with average risk factor values) in their discussion of whether to embrace new CVD risk markers as tools for targeting or personalizing statin therapy. They also described another well-known apparent paradox: even risk markers that are strongly associated with the outcome of interest (relative risks of 3 to 5 or even larger) often seem to contribute little in terms of discrimination or reclassification.2
Pletcher MJ, Tice JA, Pignone M. Modeling Cardiovascular Disease Prevention. JAMA. 2010;303(9):835. doi:10.1001/jama.2010.188
* * SCHEDULED MAINTENANCE * *
The JAMA Network Sites will be conducting routine maintenance from 10/20/2017 through 10/21/2017. During this window access to content and authentication may be intermittently available. The JAMA Store will be completely unavailable during the maintenance window.