Updating the Scottish national cardiovascular risk score: ASSIGN version 2.0
Authors' conclusion
The recalibrated ASSIGN V.2.0 will give a more accurate estimation of contemporary ASCVD risk in Scotland.
Study context
- Population
- Scotland-resident participants from UK Biobank and the Generation Scotland Scottish Family Health Study (2006–2010), aged 40–69 and without previous atherosclerotic cardiovascular disease (ASCVD); external evaluation in UK Biobank participants not resident in Scotlandderivation cohort (57% females and a mean age of 55)
- Participants
- 44,947 participants
- Predictors
- The original ASSIGN predictor variables and weights
- Predicted outcome
- 10-year risk of ASCVD
Methodological detailssex-specific risk equation, external evaluation
- Sex-specific risk equation
- External evaluation
Model performance
As reported in the abstract
| Test or model | Median predicted 10-year risk, females | Median predicted 10-year risk, males | PPV at 20% threshold | NPV at 20% threshold | PPV at 10% threshold | NPV at 10% threshold |
|---|---|---|---|---|---|---|
| Original ASSIGN (evaluation cohort) | 10.6% | 15.1% | 16.3% | 94.4% | ||
| ASSIGN V.2.0 (recalibrated, evaluation cohort) | 4% | 8.9% | 16.8% | 94.6% |
Median predicted 10-year risk, females
Original ASSIGN (evaluation cohort)10.6%
ASSIGN V.2.0 (recalibrated, evaluation cohort)4%
Median predicted 10-year risk, males
Original ASSIGN (evaluation cohort)15.1%
ASSIGN V.2.0 (recalibrated, evaluation cohort)8.9%
PPV at 20% threshold
Original ASSIGN (evaluation cohort)16.3%
ASSIGN V.2.0 (recalibrated, evaluation cohort)— not stated in the abstract
NPV at 20% threshold
Original ASSIGN (evaluation cohort)94.4%
ASSIGN V.2.0 (recalibrated, evaluation cohort)— not stated in the abstract
PPV at 10% threshold
Original ASSIGN (evaluation cohort)— not stated in the abstract
ASSIGN V.2.0 (recalibrated, evaluation cohort)16.8%
NPV at 10% threshold
Original ASSIGN (evaluation cohort)— not stated in the abstract
ASSIGN V.2.0 (recalibrated, evaluation cohort)94.6%
- Observed 10-year risk, females
- 6%
- Observed 10-year risk, males
- 11.4%
Further findings
Regression-adjusted model
- Similar improvements were achieved using the regression-adjusted model
Rederivation of ASSIGN
- Only modest improvements in calibration and discrimination beyond simple recalibration
Original publication
Updating the Scottish national cardiovascular risk score: ASSIGN version 2.0. Heart. Published 16 January 2025. doi:10.
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