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To the Editor: Although the study by Dr Greenland and colleagues¹ documented the high frequency of at least 1 of the 4 major risk factors among patients with CHD, their data provide no clear measure of the power of this risk profile to predict high risk of CHD events.

Using data from the authors' Table 1, I used likelihood ratio (LR) analysis^2-5 to compute the predictive power of having at least 1 risk factor. The sensitivity, specificity, and complement of specificity (100 - specificity) were derived for the combined data of the 3 studies that Greenland et al described. The likelihood ratio for an event (ie, a positive LR) in odds:1 units is a prevalence-independent measure calculated as the sensitivity divided by (100 - specificity). An LR of 2.0 or less denotes low predictive power and an LR of 9.0 or more denotes high predictive power. Table 1 shows the . . . [Full Text of this Article]

Arnold M. Weissler, MD
Mayo Clinic and Medical School
Rochester, Minn

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