To the Editor: According to the review by Dr Tzoulaki and colleagues,1 most studies that claimed improved predictive performance beyond the Framingham risk score (FRS) had flaws in their design, analyses, and reporting. To interpret these observations, 2 questions are pertinent: what did the original studies aim to investigate, and what constitutes a claim?
Ferket BS, van Kempen BJH, Janssens ACJW. Assessing Predictive Performance Beyond the Framingham Risk Score. JAMA. 2010;303(14):1368–1369. doi:10.1001/jama.2010.388
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