Association is Not the Same as Accuracy

Autor: Luis C. L. Correia, Carolina E. Barbosa
Rok vydání: 2013
Předmět:
Zdroj: Arquivos Brasileiros de Cardiologia.
ISSN: 0066-782X
DOI: 10.5935/abc.20130251
Popis: When Santos et al1 have concluded that risk scores correlate with coronary anatomy, they considered all analyses performed: statistical correlation analysis with the non parametric Spearman test2 and the predictive ability of those scores to discriminate individuals who might and might not have a coronary artery lesion ≥ 50%, which was initially determined by using the non-parametric Mann-Whitney test2, and was later assessed by using C statistics (area under the ROC curve)3. As shown in the results, that study emphasizes both analyses: assessment of the existence of a relationship between risk scores and coronary anatomy (Table 3)1 and the predictive ability of the scores to discriminate who might have coronary lesion ≥ 50% (Chart 1)1. Thus, the word "correlation" cited in the manuscript1 was used as the "relationship between risk scores and coronary anatomy". The TIMI4 and GRACE5,6 risk scores have not been primarily developed to predict coronary lesion, but adverse clinical events. Thus, they are not supposed to have a strong discriminatory power to assess coronary lesion ≥ 50% or any other variable different from the specific clinical events of the original model. Nevertheless, they showed an ability that cannot be overlooked7 to discriminate who will or will not have coronary lesion ≥ 50% as follows: TIMI risk score, area under the ROC curve = 0.704; hospital GRACE score, area under the ROC curve = 0.623; 6-month GRACE score, area under the ROC curve = 0.562. It is worth noting that, for the TIMI risk score, the area under the ROC curve in the study by Santos et als.1 was greater than that for the specific events of the original model of development (area under the ROC curve = 0.65)4. Similarly, the TIMI risk score, despite its limited predictive ability7 for adverse clinical events, due to its clinical relevance and practicality, is one of the most used models worldwide, recommended by national and international guidelines. Sincerely, Elizabete Silva dos Santos Luciano de Figueiredo Aguiar Filho Luiz Minuzzo Roberta de Souza Ari Timerman
Databáze: OpenAIRE
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