In Reply We thank Maron et al and Östman-Smith et al for their interest in our study.1 We recognize that risk stratification in adults with hypertrophic cardiomyopathy (HCM) can be a controversial issue but also contend that stated differences in methods are somewhat exaggerated, given that all methods are based on the assessment of very similar clinical risk markers. The concern raised by Maron et al relates to the degree to which risk estimates are quantified. In 2014, the European Society of Cardiology published a validated quantitative risk score; this has been subsequently revalidated in a global study including North American centers2 and has been subject to a meta-analysis using patient-level data.3 The contradictory evidence cited by Maron et al is largely from their own center.
Norrish G, Elliott P, Kaski JP. Concerns About the HCM Risk-Kids Study—Reply. JAMA Cardiol. 2020;5(3):363–364. doi:10.1001/jamacardio.2019.5789
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