Using SCORE2 with a risk chart or online calculator: impact on model performance, treatment eligibility, and cardiovascular disease prevention
Authors' conclusion
Risk assessment using SCORE2 risk charts yields too high predicted risks and too broad treatment eligibility. By avoiding rounding of risk factors, the online calculator shows better discrimination.
Study context
- Population
- Individuals without established Cardiovascular Disease (CVD) or diabetes mellitus, from CPRD (UK, Europe’s low risk region) and HAPIEE (Czech Republic and Poland, high risk region, and Lithuania, very high risk region)CPRD (UK, low risk region) 977,616 · HAPIEE (Czech Republic, Poland, Lithuania; high/very high risk region) 11,739Events: 22,898
- Predictors
- SCORE2 risk via an online calculator (unrounded SCORE2 algorithm) and via risk charts from the 2021 ESC Prevention Guidelines
- Predicted outcome
- CVD events
Model performance
As reported in the abstract
10-year risk
Difference in C-statistic
+0.010
95% CI 0.008–0.012
low risk region
Difference in C-statistic
+0.008
95% CI 0.005–0.010
high/very high risk region
Further findings
| Outcome | Values |
|---|---|
| Median predicted 10-year risk | risk charts, low risk region median 4.0% (IQR 2.0–6.0) · calculator, low risk region median 3.7% (IQR 2.3–5.8) · risk charts, high/very high-risk region median 9.0% (IQR 5.0–15.0) · calculator, high/very high-risk region median 8.4% (IQR 4.5–13.9) |
| Treatment eligibility | risk charts, low risk region 6.3% · calculator, low risk region 4.0% · risk charts, high/very high risk region 51% · calculator, high/very high risk region 43% |
| Events prevented per 1000 treated (assuming a 50% relative risk reduction) | calculator, low-risk region 53 per 1000 treated · risk charts, low-risk region 46 per 1000 treated · calculator, high/very-high-risk region 80 per 1000 treated · risk charts, high/very-high-risk region 74 per 1000 treated |
- Median predicted 10-year risk: Predicted risks were higher with the risk charts than with the online calculator.
Follow-up
- Median follow-up
- 8.4 years [interquartile range (IQR) 5.0-10.4]
Original publication
Using SCORE2 with a risk chart or online calculator: impact on model performance, treatment eligibility, and cardiovascular disease prevention. Eur Heart J Qual Care Clin Outcomes. Published 10 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →