Appraisal of Cardiovascular 10-yr Risk Scores: A Rapid Systematic Review

Globally, the burden of cardiovascular disease is on the rise. Despite WHOs and the UNs frantic efforts, it appears less probable that the 25 by 25 aim will be met. Early identification of at-risk cases using a risk scoring system can aid in achieving these goals, however for primary and secondary prevention, suitability of these scoring systems, for the countries with medium to low resources, including Asians, with respect to accuracies is a challenge as majority of them are developed from non-Asian cohorts. In light of methodological considerations, risk attribution, and policy consequences, we included and described, restricting our search but sytematically, with five widely used global tools for CVD risk 10-year prediction--FRS, WHO CVD, QRISK, ASCVD, and SCORE--and their updated versions, altogether 11, published during 1970-2023. In general, the results of consolidated risk ratings and summarization showed that these algorithms can differentiate CVD 10-yr risk by 63-86% accurately, considering both for internal and external validity. Further, we discuss their methodological perspectives, ad hoc use, and suggest prospects. RegistrationOpen Science Framework (https://osf.io/72v48) HighlightsO_LIGlobally and optimally used cardiovascular disease (CVD) risk scoring algorithms have diverse accuracies, generalizability, and levels of evidence based on study designs, analyses, and given gold standards. C_LIO_LIAlthough validated fair to excellent, still the performance of these tools can be increased from 12 to 37%, both for internal and external accuracy, which can have a positive impact on cost and public health. C_LIO_LILifestyle and related changes due to gene-environment interaction, these algorithms are liable to change, so we need to update, validate, and fit them accordingly. C_LIO_LIImplementational, methodological, technological, and cost-related issues need to be addressed for a country or a state-specific algorithm to be up taken, updated, or validated. C_LI