Evidence mapPaperPMID 31291803Full record

ArticleJournal of the American Heart Association2019

Atherosclerotic Cardiovascular Disease Risk Prediction in Disaggregated Asian and Hispanic Subgroups Using Electronic Health Records.

Fatima Rodriguez, Sukyung Chung, Manuel R Blum, Adrien Coulet, Sanjay Basu, Latha P Palaniappan

Open access · goldAbstract read
In one paragraph

Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed
8.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 112 citations in OpenAlex.

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  9. Population-Level Gaps in Coronary Artery Disease Care: A Focused Review.Methodist DeBakey cardiovascular journal · 2025
    Review
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10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 3 countries.

Fatima Rodriguez1 Division of Cardiovascular Medicine Stanford University School of Medicine Stanford CA.
Sukyung Chung2 Palo Alto Foundation Research Institute Palo Alto CA.
Manuel R Blum1 Division of Cardiovascular Medicine Stanford University School of Medicine Stanford CA.
Adrien Coulet5 Université de Lorraine CNRS Inria LORIA Nancy France.
Sanjay Basu7 Departments of Medicine and of Health Research and Policy Centers for Primary Care and Outcomes Research and Center for Population Health Sciences Stanford University Stanford CA.
Latha P Palaniappan3 Division of Primary Care and Population Health Stanford University School of Medicine Stanford CA.
Stanford University · USStanford Medicine · USUniversity Hospital of Bern · CH

Funding

Stanford Medicine Center for Longevity and Healthy Aging Research Education CoreP30AG059307 · STANFORD UNIVERSITY · 2025 to 2025
$654k
META - Mentor, Educate, Train, Advocate: Patient Oriented Researchers in Cardiometabolic DiseaseK24HL150476 · NHLBI · STANFORD UNIVERSITY · 2022 to 2025
$479k
NHLBI NIH HHS K01 HL144607NHLBI NIH HHS K24 HL150476NHLBI NIH HHS R01 HL126172NIA NIH HHS P30 AG059307NIMHD NIH HHS R01 MD007012
6 · The paper itself

Abstract

Background Risk assessment is the cornerstone for atherosclerotic cardiovascular disease ( ASCVD ) treatment decisions. The Pooled Cohort Equations ( PCE ) have not been validated in disaggregated Asian or Hispanic populations, who have heterogeneous cardiovascular risk and outcomes. Methods and Results We used electronic health record data from adults aged 40 to 79 years from a community-based, outpatient healthcare system in northern California between January 1, 2006 and December 31, 2015, without ASCVD and not on statins. We examined the calibration and discrimination of the PCE and recalibrated the equations for disaggregated race/ethnic subgroups. The cohort included 231 622 adults with a mean age of 53.1 (SD 9.7) years and 54.3% women. There were 56 130 Asian (Chinese, Asian Indian, Filipino, Japanese, Vietnamese, and other Asian) and 19 760 Hispanic (Mexican, Puerto Rican, and other Hispanic) patients. There were 2703 events (332 and 189 in Asian and Hispanic patients, respectively) during an average of 3.9 (SD 1.5) years of follow-up. The PCE overestimated risk for NHW s, African Americans, Asians, and Hispanics by 20% to 60%. The extent of overestimation of ASCVD risk varied by disaggregated racial/ethnic subgroups, with a predicted-to-observed ratio of ASCVD events ranging from 1.1 for Puerto Rican patients to 1.9 for Chinese patients. The PCE had adequate discrimination, although it varied significantly by race/ethnic subgroups (C-indices 0.66-0.83). Recalibration of the PCE did not significantly improve its performance. Conclusions Using electronic health record data from a large, real-world population, we found that the PCE generally overestimated ASCVD risk, with marked heterogeneity by disaggregated Asian and Hispanic subgroups.

Indexed as

AdultAsianAtherosclerosisChinaElectronic Health RecordsFemaleHispanic or LatinoHumansIndiaJapanMaleMexican AmericansMiddle AgedPhilippinesPuerto RicoRisk Assessmentdisparitieselectronic health recordspreventionrisk assessment

Identifiers

PMID31291803
PMCPMC6662141
OpenAlexW2958550040

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.