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Research Article

Personalized Prediction of Lifetime Benefits with Statin Therapy for Asymptomatic Individuals: A Modeling Study

  • Bart S. Ferket,

    Affiliations: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands, Department of Radiology, Erasmus MC, Rotterdam, the Netherlands

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  • Bob J. H. van Kempen,

    Affiliations: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands, Department of Radiology, Erasmus MC, Rotterdam, the Netherlands

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  • Jan Heeringa,

    Affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands

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  • Sandra Spronk,

    Affiliations: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands, Department of Radiology, Erasmus MC, Rotterdam, the Netherlands

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  • Kirsten E. Fleischmann,

    Affiliation: Department of Medicine, University of California, San Francisco, California, United States of America

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  • Rogier L. G. Nijhuis,

    Affiliation: Department of Cardiology, Ziekenhuisgroep Twente, Hengelo, the Netherlands

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  • Albert Hofman,

    Affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands

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  • Ewout W. Steyerberg,

    Affiliation: Department of Public Health, Erasmus MC, Rotterdam, the Netherlands

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  • M. G. Myriam Hunink mail

    m.hunink@erasmusmc.nl

    Affiliations: Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands, Department of Radiology, Erasmus MC, Rotterdam, the Netherlands, Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, United States of America

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  • Published: December 27, 2012
  • DOI: 10.1371/journal.pmed.1001361

Reader Comments (2)

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What about deprivation and ethnicity?

Posted by MichaelSoljak on 30 Dec 2012 at 20:14 GMT

This is an interesting simulation study, but the process of variable selection appears to be seriously flawed. The authors state that they chose the variables included "because they can be reliably and easily obtained during an office-based health check", rather than by using empirical methods. In the United Kingdom, deprivation and ethnicity (both of which can easily be obtained during a health check) were included in the QRISK2 model (Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, et al. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ 2008;336, Link: http://www.bmj.com/conten...) as a result of empirical variable selection. These may not be risk factors in the Rotterdam study population, but without a proper variable selection process we will never know.

No competing interests declared.