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Using the Race Model Inequality to Quantify Behavioral Multisensory Integration Effects

Published on: May 10, 2019

Reevaluating the Use of Race/Ethnicity in the MESA Risk Score

Quinn White1, Spencer Hansen1, Brittany Saldivar Murphy2

  • 1University of Washington Seattle WA USA.

Journal of the American Heart Association
|July 3, 2026
PubMed

Insights

A new race-free MESA risk score estimates coronary heart disease risk comparably to the original. This cardiovascular disease tool performs similarly in calibration and discrimination, offering a more inclusive approach.

Area of Science:

  • Cardiovascular disease research
  • Biostatistics
  • Public health

Background:

  • Cardiovascular disease risk scores are widely used in clinical practice and research.
  • The Multi-Ethnic Study of Atherosclerosis (MESA) risk score estimates 10-year coronary heart disease risk.
  • The original MESA score incorporated race/ethnicity, necessitating careful consideration of its inclusion.

Purpose of the Study:

  • To develop and evaluate a race-free version of the MESA risk score.
  • To compare the performance of the race-free MESA score against the original score.
  • To assess the impact of removing race/ethnicity on cardiovascular risk prediction.

Main Methods:

  • Utilized data from the MESA cohort (individuals aged 45-84, free of prevalent cardiovascular disease).
  • Employed a 2-step regularization procedure: LASSO for variable selection and ridge regression for preventing overfitting.
  • Excluded race/ethnicity and interaction terms with race/ethnicity as candidate predictors.

Main Results:

  • The race-free MESA risk score achieved an area under the ROC curve of 0.820 (95% CI, 0.801-0.840).
  • No significant difference was observed in the area under the ROC curve compared to the original score (estimate, 0.0032).
  • The discrimination slope for the race-free model (0.101) was comparable to the original MESA risk score (0.0937).

Conclusions:

  • A race-free MESA risk score was successfully developed.
  • The race-free score demonstrates comparable calibration and discrimination to the original MESA risk score.
  • This study provides a validated, race-independent tool for cardiovascular disease risk assessment.
Abstract

Keywords:
cardiovascular risk scorecoronary artery calciumcoronary heart diseaserace‐free modelrisk prediction

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