Key result
Planned systematic review examines adding behavioral and psychological factors to CVD risk prediction models.
Why the study?
The review aims to evaluate how behavioural and psychological factors are incorporated into CVD risk prediction models, assess their impact on model performance metrics, and identify variables consistently linked to predictive improvements.
Does the inclusion of behavioural and psychological predictors improve model performance in adult populations at risk of CVD?
Systematic Review
Does the inclusion of behavioural and psychological predictors improve model performance in adult populations at risk of CVD?
This protocol outlines a planned systematic review to evaluate the extent to which integrating behavioural and psychological factors improves the predictive accuracy of cardiovascular disease risk models.
OBJECTIVES: This systematic review aims to: (1) evaluate how behavioural and psychological factors have been incorporated into cardiovascular disease (CVD) risk prediction models; (2) assess their impact on model performance metrics such as area under the curve (AUC) and net reclassification index (NRI); and (3) identify which specific variables are most consistently associated with predictive improvements. This protocol is reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols (PRISMA-P) 2015, and the systematic review will follow the Cochrane Handbook and report findings based on PRISMA 2020. DESIGN: A systematic review protocol developed in accordance with the (PRISMA-P) 2015 guidelines. DATA SOURCES: Systematic searches will be carried out in PubMed, Scopus, Web of Science and Google Scholar, limited to studies published from 2019 to 2024. ELIGIBILITY CRITERIA: Peer-reviewed original studies involving adult populations (≥18 years) at risk of CVD, incorporating at least one behavioural or psychological variable into a CVD risk prediction model. Studies must report model performance metrics such as AUC or NRI. Studies focusing solely on biochemical or demographic factors, paediatric populations, or non-CVD outcomes will be excluded. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers will screen eligible studies, extract data and assess study quality using the Newcastle-Ottawa Scale and Quality in Prognostic Studies tool. A narrative synthesis will be performed, with meta-analysis conducted if feasible. ETHICS AND DISSEMINATION: Ethical approval is not required for this study. Findings will be disseminated through peer-reviewed publication and conference presentations. PROSPERO REGISTRATION NUMBER: CRD420251014218.
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Tang et al. (2025) conducted a systematic review in Cardiovascular disease risk. Behavioral and psychological factors in risk prediction models vs. Traditional CVD risk models using only demographic and biochemical variables was evaluated on Model performance improvements measured by area under the curve, net reclassification index or other predictive accuracy metrics. This protocol outlines a planned systematic review to evaluate the impact of incorporating behavioral and psychological factors into cardiovascular disease risk prediction models without reporting clinical results.
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