title: Poor predictive ability of the risk chart SCORE in a Danish population.
abstract: BACKGROUND
  In Denmark, the European risk chart Systematic COronary Risk Evaluation (SCORE) from the European Society of Cardiology is recommended for use in cardiovascular prevention. Nevertheless, its predictive ability in a Danish population has never been investigated. The purpose of this study was therefore to assess the predictive ability of the SCORE risk chart with regard to fatal cardiovascular risk according to the socio-demographic factors of age, sex, income and education in a Danish population.
  
  
  METHODS
  Data from the third Copenhagen City Heart Study (n = 4,224) were linked to the Danish Cause of Death Registry. Calibration (i.e. Hosmer-Lemeshow goodness-of-fit), expected-to-observed (E/O) mortality ratios in the total population and for subgroups, as well as discrimination (i.e. sensitivity, specificity, Area Under the Receiver Operator Characteristic (AUROC) and predictive values) were tested. Both SCORE high-risk and low-risk were applied for comparison.
  
  
  RESULTS
  The results showed that both SCORE high-risk and low-risk performed acceptably in terms of discrimination (AUROC ≈ 0.7-0.8); however, calibration for both SCORE charts was inadequate (χ2 > 20; p < 0.001). E/O-ratios varied with age, sex and socioeconomic status.
  
  
  CONCLUSIONS
  There is a need to recalibrate SCORE to risk levels and risk factor distribution in the Danish population.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Forskningscenter for Forebyggelse og Sundhed, Koncern Plan Udvikling og Kvalitet, Afsnit 84/85, Glostrup Hospital, 2600 Glostrup, Denmark. m@saidj.dk
authors.forename: Madina
authors.initials: M
authors.lastname: Saidj
authors.forename: Torben
authors.initials: T
authors.lastname: Jørgensen
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
authors.forename: Anders
authors.initials: A
authors.lastname: Borglykke
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D002138:Calibration; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control; D002423:Cause of Death; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors