Published 1 September 2009, doi:10.1136/bmj.b3514
Cite this as: BMJ 2009;339:b3514

Letters

QRISK validation and evaluation

ASSIGN, QRISK, and validation

The first 150 words of the full text of this article appear below.

We challenge the recent QRISK validation and editorial concluding that QRISK is the cardiovascular risk score for the United Kingdom.^{1 2}

ASSIGN, QRISK’s precursor, was launched in Scotland before QRISK appeared.³ Predicting that scores omitting social deprivation (socioeconomic status) as a risk factor could exacerbate social gradients in disease, we developed ASSIGN to include it. ASSIGN was adopted without external validation because it correlated highly with the gold standard Framingham score. Discriminating rather better, even after adjustment for self-testing bias, it removed Framingham’s social inequity.

Subsequent to ASSIGN’s launch, QRISK authors told us that they were developing their own score. Our offer of collaborative comparison was not accepted, and QRISK coefficients were kept secret after its launch. The initial partisan publication, however, did show that ASSIGN discriminated better than Framingham in the QRESEARCH database where QRISK originated.⁴

We have not seen how QRISK deals with social deprivation in analyses similar to . . . [Full text of this article]

¹ Cardiovascular Epidemiology Unit, Institute for Cardiovascular Research, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, ² General Practice and Primary Care, University of Glasgow

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This article has been cited by other articles:

• Collins, G. S, Altman, D. G (2009). Authors' reply. BMJ 339: b3516-b3516 [Full text]  

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