ArticleMedical care2017
The Veterans Affairs Cardiac Risk Score: Recalibrating the Atherosclerotic Cardiovascular Disease Score for Applied Use.
Article in Medical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- An Evidence Map of the Women Veterans' Health Literature, 2016 to 2023: A Systematic Review.JAMA network open · 2025Pooled it
- Association between Statins Prescribed for Primary and Secondary Prevention and Major Adverse Cardiac Events among Older Adults with Frailty: A Systematic Review.Drugs & aging · 2020 · on this mapPooled it
- 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2019Guideline
- Performance of the Framingham risk models and pooled cohort equations for predicting 10-year risk of cardiovascular disease: a systematic review and meta-analysis.BMC medicine · 2019Pooled it
- Feasibility and acceptability of an everyday patient-centered discussion model for primary care: An exploratory, single-center study in the VA primary care setting.PEC innovation · 2026Article
- New 10-Year Atherosclerosis Cardiovascular Disease Risk Score for Asian and American Indian Women Service Members.JACC. Asia · 2026Article
- An Everyday Patient-Centered Discussion Model for Primary Care: Protocol for a Feasibility and Acceptability Study of the Zeroing in on Individualized, Patient-Centered Decisions (ZIP) Approach.JMIR research protocols · 2025Article
- Polygenic risk scores improve CAD risk prediction in individuals at borderline and intermediate clinical risk.NPJ cardiovascular health · 2025Article
- Obesity Is Increasing in Liver Transplant Recipients and Exacerbates Cardiovascular Risk: A Single-Centre European Study.Obesity surgery · 2024Article
- Recalibrating the Genetics and Epidemiology of Colorectal Cancer Consortium Environmental Risk Score for Use in US Veterans.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Coronary Disease Risk Prediction, Risk Reduction, and Postoperative Myocardial Injury.The Medical clinics of North America · 2024Review
- EXIST: EXamining rIsk of excesS adiposiTy-Machine learning to predict obesity-related complications.Obesity science & practice · 2024Article
- Uses of Social Determinants of Health Data to Address Cardiovascular Disease and Health Equity: A Scoping Review.Journal of the American Heart Association · 2023Article
- Polygenic Risk Scores for Cardiovascular Disease: A Scientific Statement From the American Heart Association.Circulation · 2022Review
- Using Prescription Drug Monitoring Program Data to Assess Likelihood of Incident Long-Term Opioid Use: a Statewide Cohort Study.Journal of general internal medicine · 2021Article
- Combined risk modelling approach to identify the optimal carotid revascularisation approach.Stroke and vascular neurology · 2021Article
- Optimal cholesterol treatment plans and genetic testing strategies for cardiovascular diseases.Health care management science · 2021Article
- Risk prediction models for atherosclerotic cardiovascular disease: A systematic assessment with particular reference to Qatar.Qatar medical journal · 2021Article
- Optimizing Atherosclerotic Cardiovascular Disease Risk Estimation for Veterans With Diabetes Mellitus.Circulation. Cardiovascular quality and outcomes · 2020Article
- Estimation of Atherosclerotic Cardiovascular Disease Risk Among Patients in the Veterans Affairs Health Care System.JAMA network open · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAccurately estimating cardiovascular risk is fundamental to good decision-making in cardiovascular disease (CVD) prevention, but risk scores developed in one population often perform poorly in dissimilar populations. We sought to examine whether a large integrated health system can use their electronic health data to better predict individual patients' risk of developing CVD.
methodsWe created a cohort using all patients ages 45-80 who used Department of Veterans Affairs (VA) ambulatory care services in 2006 with no history of CVD, heart failure, or loop diuretics. Our outcome variable was new-onset CVD in 2007-2011. We then developed a series of recalibrated scores, including a fully refit "VA Risk Score-CVD (VARS-CVD)." We tested the different scores using standard measures of prediction quality.
resultsFor the 1,512,092 patients in the study, the Atherosclerotic cardiovascular disease risk score had similar discrimination as the VARS-CVD (c-statistic of 0.66 in men and 0.73 in women), but the Atherosclerotic cardiovascular disease model had poor calibration, predicting 63% more events than observed. Calibration was excellent in the fully recalibrated VARS-CVD tool, but simpler techniques tested proved less reliable.
conclusionsWe found that local electronic health record data can be used to estimate CVD better than an established risk score based on research populations. Recalibration improved estimates dramatically, and the type of recalibration was important. Such tools can also easily be integrated into health system's electronic health record and can be more readily updated.
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