Baseline event rate, the Concorde fallacy, and the topography of cardiac risk

Area of Science:

• Cardiology
• Medical Statistics
• Risk Assessment

Background:

• Cardiac risk stratification aims to identify individuals susceptible to cardiac events.
• The medical literature presents numerous novel risk assessment methods and markers.
• Existing risk assessment literature faces criticism for statistically unjustified claims.

Purpose of the Study:

• To explore an alternative explanation for the limitations in baseline cardiac risk assessment.
• To propose that current cardiac risk models commit the Concorde fallacy.
• To introduce risk topography as a novel method to enhance cardiac risk models.

Main Methods:

• This study presents a hypothesis, not empirical data.
• It involves a theoretical exploration of logical fallacies in risk modeling.
• The concept of risk topography is introduced as a potential solution.

Main Results:

• Current cardiac risk models may be fundamentally limited by a logical error known as the Concorde fallacy.
• The Concorde fallacy suggests that focusing on avoiding a negative outcome can lead to suboptimal decisions.
• This theoretical flaw may explain the overestimation or misinterpretation of risk in current models.

Conclusions:

• The Concorde fallacy offers a new perspective on the limitations of existing cardiac risk stratification.
• Risk topography is proposed as a novel conceptual framework to potentially overcome these limitations.
• Further research is needed to validate the impact of the Concorde fallacy and the utility of risk topography in clinical practice.