title: Improvement in Cardiovascular Risk Prediction with Electronic Health Records.
abstract: The aim of this study was to compare the QRISKII, an electronic health data-based risk score, to the Framingham Risk Score (FRS) and atherosclerotic cardiovascular disease (ASCVD) score. Risk estimates were calculated for a cohort of 8783 patients, and the patients were followed up from November 29, 2012, through June 1, 2015, for a cardiovascular disease (CVD) event. During follow-up, 246 men and 247 women had a CVD event. Cohen's kappa statistic for the comparison of the QRISKII and FRS was 0.22 for men and 0.23 for women, with the QRISKII classifying more patients in the higher-risk groups. The QRISKII and ASCVD were more similar with kappa statistics of 0.49 for men and 0.51 for women. The QRISKII shows increased discrimination with area under the curve (AUC) statistics of 0.65 and 0.71, respectively, compared to the FRS (0.59 and 0.66) and ASCVD (0.63 and 0.69). These results demonstrate that incorporating additional data from the electronic health record (EHR) may improve CVD risk stratification.
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Mindy M
authors.initials: MM
authors.lastname: Pike
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Decker
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Nicholas B
authors.initials: NB
authors.lastname: Larson
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: St Sauver
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Takahashi
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Division of Cardiovascular Diseases in the Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Véronique L
authors.initials: VL
authors.lastname: Roger
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.|Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Walter A
authors.initials: WA
authors.lastname: Rocca
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN, USA.|Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Miller
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Olson
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Jyotishman
authors.initials: J
authors.lastname: Pathak
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Bielinski.suzette@mayo.edu.
authors.forename: Suzette J
authors.initials: SJ
authors.lastname: Bielinski
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology*; D057225:Data Mining / Q000379:methods*; D003661:Decision Support Techniques; D057286:Electronic Health Records; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: ASCVD; Biobank; Cardiovascular; Framingham risk score; QRISK