This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Prognosis/ Outcomes  • Cardiac Diagnostic Tests  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Greenland and colleagues¹ reported that both the Framingham Risk Score (FRS) and the coronary artery calcium score (CACS) were predictive of coronary artery disease. The authors also reported that across categories of FRS, CACS was predictive of risk among patients with an FRS higher than 10%, but not with an FRS less than 10%. Furthermore, the CACS was less predictive than the FRS (hazard ratio, 3.9 vs 14.3), and only added slightly to the area under the receiver operating characteristic (ROC) curve using FRS alone.

We point out that the FRS has a wide confidence interval (5.1%-6.9%) depending on the number of initial measurements in this type of patient² and so it is possible that no significant difference exists given the size of the ROC envelope for the FRS and the small numbers of events that occurred in the study. The original cohort for the FRS . . . [Full Text of this Article]

Anthony S. Wierzbicki, MD, DPhil
anthony.wierzbicki@kcl.ac.uk
Department of Chemical Pathology
St Thomas' Hospital
London, England

Patrick J. Twomey, MD, MRCPath
The Ipswich Hospital
Suffolk, England

Timothy M. Reynolds, MD, FRCPath
Department of Chemical Pathology
Queen's Hospital
Staffordshire, England

RELATED ARTICLES

Use of Coronary Calcification Scores to Predict Coronary Heart Disease
Mark J. Pletcher, Jeffrey A. Tice, and Michael Pignone
JAMA. 2004;291(15):1831-1832.
EXTRACT | FULL TEXT  

Use of Coronary Calcification Scores to Predict Coronary Heart Disease
Matthew J. Budoff, James Ehrlich, Harvey S. Hecht, and John A. Rumberger
JAMA. 2004;291(15):1832.
EXTRACT | FULL TEXT  

Use of Coronary Calcification Scores to Predict Coronary Heart Disease—Reply
Robert C. Detrano, Philip Greenland, Terence M. Doherty, Stanley P. Azen, and Laurie LaBree
JAMA. 2004;291(15):1832-1833.
EXTRACT | FULL TEXT  

Coronary Artery Calcium Score Combined With Framingham Score for Risk Prediction in Asymptomatic Individuals
Philip Greenland, Laurie LaBree, Stanley P. Azen, Terence M. Doherty, and Robert C. Detrano
JAMA. 2004;291(2):210-215.
ABSTRACT | FULL TEXT