{"doi":"10.1136/bmj.e3318","title":"Comparisons of established risk prediction models for cardiovascular disease: systematic review","abstract":"<h4>Objective</h4>To evaluate the evidence on comparisons of established cardiovascular risk prediction models and to collect comparative information on their relative prognostic performance.<h4>Design</h4>Systematic review of comparative predictive model studies.<h4>Data sources</h4>Medline and screening of citations and references.<h4>Study selection</h4>Studies examining the relative prognostic performance of at least two major risk models for cardiovascular disease in general populations.<h4>Data extraction</h4>Information on study design, assessed risk models, and outcomes. We examined the relative performance of the models (discrimination, calibration, and reclassification) and the potential for outcome selection and optimism biases favouring newly introduced models and models developed by the authors.<h4>Results</h4>20 articles including 56 pairwise comparisons of eight models (two variants of the Framingham risk score, the assessing cardiovascular risk to Scottish Intercollegiate Guidelines Network to assign preventative treatment (ASSIGN) score, systematic coronary risk evaluation (SCORE) score, Prospective Cardiovascular Münster (PROCAM) score, QRESEARCH cardiovascular risk (QRISK1 and QRISK2) algorithms, Reynolds risk score) were eligible. Only 10 of 56 comparisons exceeded a 5% relative difference based on the area under the receiver operating characteristic curve. Use of other discrimination, calibration, and reclassification statistics was less consistent. In 32 comparisons, an outcome was used that had been used in the original development of only one of the compared models, and in 25 of these comparisons (78%) the outcome-congruent model had a better area under the receiver operating characteristic curve. Moreover, authors always reported better area under the receiver operating characteristic curves for models that they themselves developed (in five articles on newly introduced models and in three articles on subsequent evaluations).<h4>Conclusions</h4>Several risk prediction models for cardiovascular disease are available and their head to head comparisons would benefit from standardised reporting and formal, consistent statistical comparisons. Outcome selection and optimism biases apparently affect this literature.","journal":"BMJ","year":2012,"id":649,"datarank":0.8595149674460364,"base_score":5.730099782973575,"endowment":5.730099782973575,"self_citation_contribution":0.8595149674460364,"citation_network_contribution":0.0,"self_endowment_contribution":0.8595149674460364,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":307,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.054,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2012-05-24","fair_score":12.5,"fair_percentile":0.15391380826737028,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":37698,"name":"Konstantinos CM Siontis","orcid":null,"position":2,"is_corresponding":false},{"id":6426,"name":"George C.M. Siontis","orcid":"0000-0003-2128-9205","position":4,"is_corresponding":false},{"id":685,"name":"Ioanna Tzoulaki","orcid":"0000-0002-4275-9328","position":5,"is_corresponding":false},{"id":3375,"name":"Konstantinos C. Siontis","orcid":"0000-0002-6658-0971","position":6,"is_corresponding":false},{"id":148,"name":"John P. A. Ioannidis","orcid":"0000-0003-3118-6859","position":7,"is_corresponding":false}],"reference_count":59,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-03-01T18:20:47.508186Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":20.0,"fair_a":30.0,"fair_i":0.0,"fair_r":0.0,"fair_zscore":-2.9589,"fair_rationale":{"fair_score":12.5,"has_llm":true,"dimensions":{"F":{"name":"Findable","score":20.0,"criteria":[{"key":"f_has_doi","label":"Has a persistent DOI","kind":"deterministic","weight":1.0,"fraction":1.0,"signal":"DOI present","rationale":null},{"key":"f_repository_presence","label":"Indexed in repositories / literature DBs","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"datacite=0, pmcid=False, pmid=False","rationale":null},{"key":"f_persistent_ids","label":"Resolvable scholarly identifiers (OpenAlex)","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"no OpenAlex id","rationale":null},{"key":"f_metadata_richness","label":"Rich, machine-readable metadata","kind":"llm","weight":1.0,"fraction":0.0,"signal":null,"rationale":"The paper provides no machine-readable metadata such as structured data descriptions, controlled vocabularies, or persistent identifiers for the data or code."}]},"A":{"name":"Accessible","score":30.0,"criteria":[{"key":"a_open_access","label":"Open Access / files deposited","kind":"deterministic","weight":1.5,"fraction":1.0,"signal":"Open Access","rationale":null},{"key":"a_retrievable","label":"Free full text retrievable","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"0 OA location(s)","rationale":null},{"key":"a_access_protocol","label":"Clear data/code access protocol","kind":"llm","weight":1.0,"fraction":0.0,"signal":null,"rationale":"No protocol for accessing the underlying data or code is mentioned; the paper only describes literature search and data extraction methods."}]},"I":{"name":"Interoperable","score":0.0,"criteria":[{"key":"i_linked_data","label":"Linked datasets / DataCite relations","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"linked_datasets=0, datacite=0","rationale":null},{"key":"i_standard_ids","label":"References data via standard accessions","kind":"deterministic","weight":1.0,"fraction":0.0,"signal":"accessions=0, trials=0","rationale":null},{"key":"i_standards","label":"Standard formats, vocabularies & identifiers","kind":"llm","weight":1.0,"fraction":0.0,"signal":null,"rationale":"The paper does not specify use of standard formats, vocabularies, or identifiers for the data or models."}]},"R":{"name":"Reusable","score":0.0,"criteria":[{"key":"r_license","label":"Clear, open reuse license","kind":"deterministic","weight":1.5,"fraction":0.0,"signal":"no license","rationale":null},{"key":"r_downloads","label":"Demonstrated reuse (downloads)","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"downloads=0","rationale":null},{"key":"r_version","label":"Versioned / maintained","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"no version chain","rationale":null},{"key":"r_dataset","label":"Classified as a data resource","kind":"deterministic","weight":0.5,"fraction":0.0,"signal":"not a dataset","rationale":null},{"key":"r_reusability","label":"Data-availability statement, license & reproducibility","kind":"llm","weight":2.0,"fraction":0.0,"signal":null,"rationale":"There is no data-availability statement, license, or any information enabling reproducibility or reuse of the data or code."}]}},"suggestions":["Provide a data-availability statement with a link to a repository containing the extracted data and analysis code.","Include machine-readable metadata (e.g., using schema.org or DataCite) describing the dataset, variables, and models.","Specify the use of standard identifiers (e.g., DOIs for models, ORCID for authors) and controlled vocabularies for outcomes and risk factors.","Add a clear access protocol for the data, such as a public repository with a license (e.g., CC-BY) and instructions for reuse.","Document the data extraction process in a structured format (e.g., CSV with a data dictionary) to enhance interoperability."],"model":"deepseek/deepseek-v4-flash","agent_version":"fair_agent_v1","fulltext_source":"abstract_only"},"fair_model":"deepseek/deepseek-v4-flash","fair_agent_version":"fair_agent_v1","fair_fulltext_source":"abstract_only","fair_has_llm":true,"fair_computed_at":"2026-06-14T20:30:47.541680Z","clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}