title: Validation of the european SCORE risk chart in the healthy middle-aged Japanese.
abstract: The European Society of Cardiology developed prediction models (SCORE) for low- and high-risk populations in the European countries. However, whether or not these models are valid in different ethnicities is unknown. We aimed to evaluate the performance of the low-risk SCORE model in the general Japanese population.
  
  
  
  Healthy middle-aged Japanese participating in the NIPPON DATA80 cohort had been observed. The predicted 10-year cardiovascular death risk was calculated using the low-risk SCORE model for the overall population as well as for each gender individually. The model performance of the low-risk SCORE model was evaluated with the Harrel's c-statistics for discrimination and the Grønnesby and Borgan goodness-of-fit test for calibration.
  
  
  
  A total of 4842 participants aged 40-64 years old and 47,606 person-years were evaluated in our study. 203 (4.19%) died within the ten-years of follow-up and 44 (0.91%) CV deaths were observed. The low-risk SCORE model in the overall population had reasonable discrimination (c statistics 0.72, 95% CI 0.71-0.73) but poor calibration (R(2), 0.67, Chi-square value 6.15, p = 0.01). Discrimination was reasonable in both men (c statistics 0.71, 95% CI 0.69-0.73) and women (c statistics 0.71, 95% CI 0.70-0.73). However, calibration was poor in men (R(2), 0.22, Chi-square value 0.749, p = 0.38) compared to women (R(2), 0.96, Chi-square value 1.39, p = 0.24).
  
  
  
  Although the low-risk SCORE model performs reasonably well in women, the SCORE models generally overestimated the risk of cardiovascular death risk in the Japanese general population.
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors: Mitsuaki
authors: M
authors: Sawano
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. Electronic address: kohsaka@cpnet.med.keio.jp.
authors: Shun
authors: S
authors: Kohsaka
authors: Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.
authors: Tomonori
authors: T
authors: Okamura
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors: Taku
authors: T
authors: Inohara
authors: Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.
authors: Daisuke
authors: D
authors: Sugiyama
authors: Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
authors: Makoto
authors: M
authors: Watanabe
authors: Department of Food Science and Human Nutrition, Faculty of Agriculture, Ryukoku University, Otsu, Japan.
authors: Yasuyuki
authors: Y
authors: Nakamura
authors: Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Aya
authors: A
authors: Higashiyama
authors: Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Aya
authors: A
authors: Kadota
authors: Department of Cardiology, Keio University School of Medicine, Tokyo, Japan; Department of Health and Nutrition, University of Human Arts and Sciences, Saitama, Japan.
authors: Nagako
authors: N
authors: Okud
authors: Department of Medical Statistics, Toho University School of Medicine, Tokyo, Japan.
authors: Yoshitaka
authors: Y
authors: Murakami
authors: Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
authors: Takayoshi
authors: T
authors: Ohkubo
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Akira
authors: A
authors: Fujiyoshi
authors: Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Katsuyuki
authors: K
authors: Miura
authors: Research Institute for Lifestyle-Related Disease Prevention, Tokyo, Japan.
authors: Akira
authors: A
authors: Okayama
authors: Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan; Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Hirotsugu
authors: H
authors: Ueshima
mesh_terms: D000328:Adult; D002138:Calibration; D002309:Cardiology / Q000592:standards*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000208:ethnology*; D005006:Ethnicity; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000592:standards*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors
keywords: External validation; General population; Primary prevention; Risk score