To the Editor: The article by Dr Tzoulaki and colleagues1 provided a systematic overview of studies aiming to improve the FRS for cardiovascular disease. The authors appropriately pointed out several areas for improvement and provided an assessment of adherence to proposed criteria for such studies. We have additional considerations for consistency with recent recommendations in the field of prediction research, including a scientific statement by the American Heart Association.2
Cook NR, Moons KGM, Harrell FE. Assessing Predictive Performance Beyond the Framingham Risk Score. JAMA. 2010;303(14):1368–1369. doi:10.1001/jama.2010.389
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