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Updated: Jul 19, 2026

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
The SCORE risk model applied to recent population surveys in Norway compared to observed mortality in the general
Anja S Lindman1, Randi Selmer, Aage Tverdal
1Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway. anjal@medisin.uio.no
Aims:
To compare the predictions of the Systematic Coronary Risk Evaluation (SCORE) high- and low-risk functions applied to a recent population study with observed cardiovascular disease (CVD) mortality estimated from annual official mortality statistics in Norway.
Methods:
Data were obtained from large epidemiological surveys conducted in five Norwegian counties in 2000-2003.
Results:
A total of 32 251 men and women were investigated (aged 30-31, 40-41, 45-46, and 59-61). For men aged >or=59, more than 75% qualified for preventive treatment by having a 10-year risk >or=5%. Few women and practically no men younger than 46 years can be considered at high risk according to the SCORE risk prediction models. For men, the high-risk function overestimated and the low-risk model underestimated the CVD mortality as compared to the 10-year risks calculated from official mortality statistics (1999-2003). For women, however, both functions underestimated mortality in young individuals, whereas in the elderly an overestimation was observed.
Conclusions:
The risk predictions depended strongly on age and gender. The SCORE high-risk function overestimates the risk of fatal CVD for men in Norway, and before implementation in clinical practice, proper adjustments to national levels are required.
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