Key result
USA-derived CV risk prediction rules are linked to ~315% higher rates of independent external validation.
Why the study?
It is unknown why some cardiovascular risk clinical prediction rules receive independent external validation while others do not despite many existing CPRs.
Population
125 cardiovascular risk clinical prediction rules included in a systematic review
Comparison
CPRs with characteristics such as larger sample size, internal validation, complete reporting, USA origin, higher journal impact factor versus those without
Design
Observational study using Cox proportional hazards regression analyses
Follow-up
Median 118 months
Authors
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US-derived cardiovascular risk rules merit greater clinical consideration due to superior validation; extends evidence on geographic disparities in prediction model adoption.
Observational (n=125)
Hazard Ratio: 4.15 (95% CI 1.89–9.13)
p-value: p=0.0002
The probability for cardiovascular risk clinical prediction rules to get an independent external validation is low, but is improved by adequate sample size, internal validation, and complete reporting of risk calculation information.
Ban et al. (2018) conducted an observational in Cardiovascular risk clinical prediction rules (n=125). Derivation in the USA vs. Derivation outside the USA was evaluated on Time to first independent external validation (HR 4.15, 95% CI 1.89-9.13, p=0.0002). Cardiovascular risk clinical prediction rules derived in the USA were 4.15 times more likely to undergo independent external validation compared to those derived elsewhere.
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