The ability of the SCORE high-risk model to predict 10-year cardiovascular disease mortality in Norway.
OBJECTIVE
To evaluate the predictive accuracy of the Systematic Coronary Risk Evaluation (SCORE) project high-risk function in Norway.


RESULTS
We included 57 229 individuals screened in 1985-1992 from two population-based surveys in Norway (age groups 40-49, 50-59, and 60-69 years). The data have been linked to the Norwegian Cause of Death Registry. The SCORE high-risk algorithm for the prediction of 10-year cardiovascular disease (CVD) mortality was applied, and the risk factors entered into the model were age, sex, total cholesterol, systolic blood pressure, and smoking (yes/no). The number of expected events estimated by the SCORE model (E) was compared with the observed numbers (O). The SCORE low-risk algorithm was studied for comparison. In men, the observed number of CVD deaths was 718, compared with 1464 estimated by the SCORE high-risk function (O/E ratios 0.53, 0.53 and 0.45, for age groups 40-49, 50-59 and 60-69, respectively). In women, the observed and expected numbers were 226 and 547. The O/E ratios decreased with age (ratios 0.60, 0.45 and 0.37, respectively), i.e. the overestimation increased with age. The low-risk function predicted reasonably well for men (ratios 0.85, 0.92 and 0.79, respectively), whereas an overestimation was found for women aged 50-59 and 60-69 years (ratios 0.69 and 0.56, respectively).


CONCLUSIONS
The SCORE high-risk model overestimated the number of CVD deaths in Norway. Before implementation in clinical practice, proper adjustments to national levels are required.
Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway. anjal@medisin.uio.no
Anja S
AS
Lindman
Marit B
MB
Veierød
Jan I
JI
Pedersen
Aage
A
Tverdal
Inger
I
Njølstad
Randi
R
Selmer
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012042:Registries; D018570:Risk Assessment / Q000379:methods*