Háskóli ÍslandsUniversity of IcelandPennells, LisaKaptoge, StephenWood, AngelaSweeting, MikeZhao, XiaohuiWhite, IanBurgess, StephenWilleit, PeterBolton, ThomasMoons, Karel G Mvan der Schouw, Yvonne TSelmer, RandiKhaw, Kay-TeeGudnason, VilmundurAssmann, GerdAmouyel, PhilippeSalomaa, VeikkoKivimaki, MikaNordestgaard, Børge GBlaha, Michael JKuller, Lewis HBrenner, HermannGillum, Richard FMeisinger, ChristaFord, IanKnuiman, Matthew WRosengren, AnnikaLawlor, Debbie AVölzke, HenryCooper, CyrusMarín Ibañez, AlejandroCasiglia, EdoardoKauhanen, JussiCooper, Jackie ARodriguez, BeatrizSundström, JohanBarrett-Connor, ElizabethDankner, RachelNietert, Paul JDavidson, Karina WWallace, Robert BBlazer, Dan GBjörkelund, CeciliaDonfrancesco, ChiaraKrumholz, Harlan MNissinen, AulikkiDavis, Barry RCoady, SeanWhincup, Peter HJørgensen, TorbenDucimetiere, PierreTrevisan, MaurizioEngström, GunnarCrespo, Carlos JMeade, Tom WVisser, MarjoleinKromhout, DaanKiechl, StefanDaimon, MakotoPrice, Jackie FGómez de la Cámara, AgustinWouter Jukema, JLamarche, BenoîtOnat, AltanSimons, Leon AKavousi, MaryamBen-Shlomo, YoavGallacher, JohnDekker, Jacqueline MArima, HisatomiShara, NawarTipping, Robert WRoussel, RonanBrunner, Eric JKoenig, WolfgangSakurai, MasaruPavlovic, JelenaGansevoort, Ron TNagel, DorotheaGoldbourt, UriBarr, Elizabeth L MPalmieri, LuigiNjølstad, IngerSato, ShinichiMonique Verschuren, W MVarghese, Cherian VGraham, IanOnuma, OyereGreenland, PhilipWoodward, MarkEzzati, MajidPsaty, Bruce MSattar, NaveedJackson, RodRidker, Paul MCook, Nancy RD'Agostino, Ralph BThompson, Simon GDanesh, JohnDi Angelantonio, EmanueleTipping, Robert WSimpson, Lara MPressel, Sara LCouper, David JNambi, VijayMatsushita, KunihiroFolsom, Aaron RShaw, Jonathan EMagliano, Dianna JZimmet, Paul ZKnuiman, Matthew WWhincup, Peter HWannamethee, S GoyaWilleit, JohannSanter, PeterEgger, GeorgCasas, Juan PabloAmuzu, AntointtteBen-Shlomo, YoavGallacher, JohnTikhonoff, ValérieCasiglia, EdoardoSutherland, Susan ENietert, Paul JCushman, MaryPsaty, Bruce MSøgaard, Anne JohanneHåheim, Lise LundAriansen, IngerTybjærg-Hansen, AnneJensen, Gorm BSchnohr, PeterGiampaoli, SimonaVanuzzo, DiegoPanico, SalvatorePalmieri, LuigiBalkau, BeverleyBonnet, FabriceMarre, Michelde la Cámara, Agustin GómezRubio Herrera, Miguel AngelFriedlander, YechielMcCallum, JohnMcLachlan, StelaGuralnik, JackPhillips, Caroline LGuralnik, JackGuralnik, JackGuralnik, JackKhaw, Kay-TeeWareham, NickSchöttker, BenSaum, Kai-UweHolleczek, BerndNissinen, AulikkiTolonen, HannaGiampaoli, SimonaDonfrancesco, ChiaraVartiainen, ErkkiJousilahti, PekkaHarald, KennetD’Agostino, Ralph BMassaro, Joseph MPencina, MichaelVasan, RamachandranD’Agostino, Ralph BMassaro, Joseph MPencina, MichaelVasan, RamachandranKayama, TakamasaKato, TakeoOizumi, ToshihideJespersen, JørgenMøller, LarsBladbjerg, Else MarieChetrit, ARosengren, AnnikaWilhelmsen, LarsBjörkelund, CeciliaLissner, LaurenNagel, DorotheaDennison, ElaineKiyohara, YutakaNinomiya, ToshiharuDoi, YasufumiRodriguez, BeatrizNijpels, GielStehouwer, Coen D ASato, ShinichiKazumasa, YamagishiIso, HiroyasuGoldbourt, UriSalomaa, VeikkoVartiainen, ErkkiKurl, SudhirTuomainen, Tomi-PekkaSalonen, Jukka TVisser, MarjoleinDeeg, Dorly J HMeade, Tom WNilsson, Peter MHedblad, BoMelander, OlleDe Boer, Ian HDeFilippis, Andrew PaulVerschuren, W M MoniqueSattar, NaveedWatt, GrahamMeisinger, ChristaKoenig, WolfgangKoenig, WolfgangMeisinger, ChristaVerschuren, W M MoniqueRosengren, AnnikaKuller, Lewis HTverdal, AageGillum, Richard FCooper, Jackie AKirkland, SusanShimbo, DaichiShaffer, JonathanSato, ShinichiKazumasa, YamagishiIso, HiroyasuDucimetiere, PierreBakker, Stephan J Lvan der Harst, PimHillege, Hans LCrespo, Carlos JAmouyel, PhilippeDallongeville, JeanAssmann, GerdSchulte, HelmutTrompet, StellaSmit, Roelof A JStott, David Jvan der Schouw, Yvonne TDesprés, Jean-PierreCantin, BernardDagenais, Gilles RLaughlin, GailWingard, DeborahKhaw, Kay-TeeTrevisan, MaurizioAspelund, ThorEiriksdottir, GudnyGuðmundsson, Elías FreyrIkram, Arfanvan Rooij, Frank J AFranco, Oscar HRueda-Ochoa, Oscar LMuka, TaulantGlisic, MarijaTunstall-Pedoe, HughVölzke, HenryHoward, Barbara VZhang, YingJolly, StaceyGallacher, JohnDavey-Smith, GeorgeCan, GünayYüksel, HüsniyeNakagawa, HideakiMorikawa, YukoMiura, KatsuyukiNjølstad, IngerIngelsson, MartinGiedraitis, VilmantasRidker, Paul MGaziano, J MichaelKivimaki, MikaShipley, MartinBrunner, Eric JShipley, MartinArndt, VolkerBrenner, HermannCook, NancyRidker, Paul MFord, IanSattar, NaveedIbañez, Alejandro MarínGeleijnse, Johanna M2020-05-152020-05-152018-11-22Pennells L, Kaptoge S, Wood A, et al. Equalization of four cardiovascular risk algorithms after systematic recalibration: individual-participant meta-analysis of 86 prospective studies. Eur Heart J 2019;40:621–310195-668X1522-9645 (eISSN)https://hdl.handle.net/20.500.11815/1806Publisher's version (útgefin grein)Aims: There is debate about the optimum algorithm for cardiovascular disease (CVD) risk estimation. We conducted head-to-head comparisons of four algorithms recommended by primary prevention guidelines, before and after 'recalibration', a method that adapts risk algorithms to take account of differences in the risk characteristics of the populations being studied. Methods and results: Using individual-participant data on 360 737 participants without CVD at baseline in 86 prospective studies from 22 countries, we compared the Framingham risk score (FRS), Systematic COronary Risk Evaluation (SCORE), pooled cohort equations (PCE), and Reynolds risk score (RRS). We calculated measures of risk discrimination and calibration, and modelled clinical implications of initiating statin therapy in people judged to be at 'high' 10 year CVD risk. Original risk algorithms were recalibrated using the risk factor profile and CVD incidence of target populations. The four algorithms had similar risk discrimination. Before recalibration, FRS, SCORE, and PCE over-predicted CVD risk on average by 10%, 52%, and 41%, respectively, whereas RRS under-predicted by 10%. Original versions of algorithms classified 29-39% of individuals aged ≥40 years as high risk. By contrast, recalibration reduced this proportion to 22-24% for every algorithm. We estimated that to prevent one CVD event, it would be necessary to initiate statin therapy in 44-51 such individuals using original algorithms, in contrast to 37-39 individuals with recalibrated algorithms. Conclusion: Before recalibration, the clinical performance of four widely used CVD risk algorithms varied substantially. By contrast, simple recalibration nearly equalized their performance and improved modelled targeting of preventive action to clinical need.621-631eninfo:eu-repo/semantics/openAccessCalibrationCardiovascular diseaseDiscriminationRisk algorithmsRisk predictionBlóðrásarsjúkdómarÁhættuþættirinfo:eu-repo/semantics/articleEuropean Heart Journal10.1093/eurheartj/ehy653