Research teams from Northwestern University Feinberg School of Medicine, New York University and Duke University will work together to assess the accuracy of the American Heart Association's new PREVENTTM risk calculator with funding from the Association's De-biasing Clinical Care Algorithms project.
The American Heart Association, celebrating 100 years of service in 2024, is the single largest non-government supporter of heart and brain health research in the U.S. The de-biasing project is funded by a grant from the Doris Duke Foundation to study the role of race and ethnicity in clinical equations and their impact on equity in disease diagnosis, healthcare delivery, or health outcomes.
Each team received a $150,000 one-year research award to further study how the risk calculator performs among people of various ages, racial and ethnic backgrounds, locations and socioeconomic levels. The calculator was initially validated using health data from more than 3 million people. The new research intends to test it against even larger datasets.
The American Heart Association PREVENTTM risk calculator is a new tool for clinicians to help people understand their risk for developing heart disease, stroke, or heart failure. It estimates cardiovascular disease risk based on health factors that assess cardiovascular, kidney, and metabolic health. Unlike the current standard for risk prediction, called the Pooled Cohort Equations (PCEs), a person's race is not included in PREVENT as a factor in determining cardiovascular risk. Previous equations included race as a surrogate for the health effects of structural and systemic inequities, such as racism, that influence cardiovascular risk. The American Heart Association developed the PREVENT calculator with data on people from diverse races and ethnicities and includes additional health measures as well as a social index to predict risk more accurately.
The research teams will comprehensively evaluate PREVENT. They will work in collaboration to assess the discrimination and calibration, cost-effectiveness and accuracy of PREVENT among different sociodemographic groups using health system data from across the U.S. They will also see how it performs compared to the PCEs.
The research projects began January 1, 2024, and include:
- Evaluating and Validating Equations Across All Race and Ethnicities – led by Sadiya S. Khan, MD, MSc, a cardiovascular epidemiologist at Northwestern University Feinberg School of Medicine in Chicago.
- Debiasing Clinical Care Algorithms - CKD-PC Analysis Core – led by Josef Coresh, MD, PhD, founding director of the Optimal Aging Institute and a professor of population health and medicine at the New York University Grossman School of Medicine in New York.
- Evaluation of Cardiovascular Risk Prediction Equations across Diverse Sociodemographic Subgroups – co-led by Michael J. Pencina, PhD, chief data scientist and Chuan Hong, Ph.D., an assistant professor of biostatistics and bioinformatics, both at Duke University School of Medicine in Durham, NC.
Khan, Coresh and Pencina were part of the volunteer writing group that developed the PREVENT equations. PREVENT was created based on data from more than 3 million people, then validated in a different dataset of more than 3 million people to show that it is accurate in people of various ages, ethnicities and geographic areas. This new collaborative project will further test how risk prediction with PREVENT applies to a diverse sample of adults and examine accuracy across race and ethnicity groups in the U.S.
"Our goal is to test these new equations using health data from a large group of people from all races and ethnicity groups to ensure they are accurate and can inform optimal preventive approaches across the life course," Khan said. "The improvement of accuracy in risk prediction means that doctors can act early to prevent disease in those at risk and the right patients can receive the right therapies based on their risk."
The teams will also develop new metrics that quantify the fairness of the PREVENT calculator and compare the cost effectiveness and fairness of PREVENT to that of the PCEs. "We hope the results of our work will provide answers on the performance of PREVENT," Hong said. "In the long term, the results can guide doctors to deliver similar care to people of all races, genders, ages and socioeconomic statuses."
The American Heart Association has funded more than $5 billion in cardiovascular, cerebrovascular and brain health research since 1949. New knowledge resulting from this funding benefits millions of lives in every corner of the U.S. and around the world.
Additional Resources
- Multimedia is available on the right column of the release link
- Spanish news release
- Call to Action: Structural Racism as a Fundamental Driver of Health Disparities (Nov 2020)
- Heart disease risk, prevention and management redefined (Oct 2023)
- Leading cardiologists reveal new heart disease risk calculator (Nov 2023)
