Prevention & lipids

Development and validation of a new algorithm for improved cardiovascular risk prediction

Nat MedPublished Risk prediction model development and external validation study

Authors' conclusion

The QR4 risk score identifies new risk groups and provides superior CVD risk prediction in the United Kingdom compared with other international scoring systems for CVD risk.

Study context

Population
UK adults; derivation 9.98 million, validation 6.79 million9.98 million derivation
Comparison
QR4 vs QRISK3, SCORE2 and atherosclerotic cardiovascular disease (ASCVD) risk scores
Outcome
Prediction of 10-year cardiovascular disease (CVD) risk (C statistic on external validation)
Follow-up
10 years
Methodological detailscause-specific Cox models, sex-specific models
  • Cause-specific Cox models
  • Sex-specific models

Performance

As reported in the abstract

C statistic on external validation
Test or modelC statistic, womenC statistic, men
QR40.835 (95% CI, 0.833-0.837)0.814 (95% CI, 0.812-0.816)
QRISK30.831 (95% CI, 0.829-0.832)0.812 (95% CI, 0.810-0.814)

C statistic, women

QR40.835 (95% CI, 0.833-0.837)
QRISK30.831 (95% CI, 0.829-0.832)

C statistic, men

QR40.814 (95% CI, 0.812-0.816)
QRISK30.812 (95% CI, 0.810-0.814)

Further findings

Novel risk factors identified

Both sexes: brain cancer, lung cancer, Down syndrome, blood cancer, COPD, oral cancer, learning disability
7
Women only: pre-eclampsia, postnatal depression
2

Original publication

Development and validation of a new algorithm for improved cardiovascular risk prediction. Nat Med. Published 18 April 2024. doi:10.1038/s41591-024-02905-y

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