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In Reply: We agree with Drs Royston and Altman that the AUROC for the logistic regression model was greater than that for the CART model. We also recognize that there remains a debate regarding the relative merits of CART compared with other models. Both the dichotomization of continuous predictors and the classification of patients into a finite number of risk categories can contribute to a reduction in the AUROC. However, the AUROC may not be the best way of assessing the accuracy of nonlinear models such as CART and newer, more complex statistical methods to assess this accuracy are being explored.¹ Our evaluation was limited to the AUROC comparison because these new methods are not fully developed or readily available.

In addition, similar to CART, logistic regression is not a perfect model and is not suited to every situation. It makes parametric assumptions that may be invalid or require complex . . . [Full Text of this Article]

Gregg C. Fonarow, MD
gfonarow@mednet.ucla.edu
Ahmanson–UCLA Cardiomyopathy Center
UCLA Medical Center
Los Angeles, Calif

Kirkwood F. Adams, Jr, MD
Division of Cardiology
University of North Carolina
Chapel Hill

William T. Abraham, MD
Division of Cardiology
Ohio State University Medical Center
Columbus

Clyde W. Yancy, MD
Division of Cardiology
University of Texas Southwestern Medical Center
Dallas

W. John Boscardin, PhD
Department of Biostatistics
University of California
Los Angeles
for the ADHERE Scientific Advisory Committee, Study Group, and Investigators

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