Performance of PREVENT Cardiovascular Risk in Electronic Health Record–Based Clinical Practice

JAMA Network Open

Chuan Hong, PhD1; Mu Niu, BS2; Haoyuan Wang, MS; Daniel M. Wojdyla, MS; Nicoleta Economou-Zavlanos, PhD; Matthew M. Engelhard, MD, PhD; Michael Pignone, MD; Manesh R. Patel, MD; Michael J. Pencina, PhD

A, Radar plot of 5-year cardiovascular disease (CVD) C-index stratified by demographic and socioeconomic subgroups. B, Radar plot of 5-year CVD calibration ratio stratified by demographic and socioeconomic subgroups.

Summary

Question  Do the Predicting Risk of Cardiovascular Disease Events (PREVENT) equations maintain 5-year cardiovascular disease (CVD) risk performance across subgroups under electronic health record (EHR) conditions with missing data?

Findings  In this cohort study using data from the Duke University Health System EHR to create a cohort of 127 151 individuals with complete data and a cohort of 406 230 individuals with partially missing data, PREVENT showed strong discrimination with consistent subgroup performance. Original PREVENT equations modestly underestimated risk; local adaptation minimally improved calibration without affecting discrimination.

Meaning  These findings suggest that the PREVENT equations can be applied to detect increased CVD risk in common clinical settings, including those with missing laboratory or vital sign data when relevant imputation is used.

Citation

Hong, Chuan, et al. “Performance of PREVENT Cardiovascular Risk in Electronic Health Record–Based Clinical Practice.” JAMA Network Open 9.4 (2026): e266838.

BibTex

@article{hong2026performance, title={Performance of PREVENT Cardiovascular Risk in Electronic Health Record–Based Clinical Practice}, author={Hong, Chuan and Niu, Mu and Wang, Haoyuan and Wojdyla, Daniel M and Economou-Zavlanos, Nicoleta and Engelhard, Matthew M and Pignone, Michael and Patel, Manesh R and Pencina, Michael J}, journal={JAMA Network Open}, volume={9}, number={4}, pages={e266838}, year={2026}, publisher={American Medical Association} }

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