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Polysocial Risk Scores: Implications for Cardiovascular Disease Risk Assessment and Management

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Abstract

Purpose of Review

To review current evidence, discuss key knowledge gaps and identify opportunities for development, validation and application of polysocial risk scores (pSRS) for cardiovascular disease (CVD) risk prediction and population cardiovascular health management.

Recent Findings

Limited existing evidence suggests that pSRS are promising tools to capture cumulative social determinants of health (SDOH) burden and improve CVD risk prediction beyond traditional risk factors. However, available tools lack generalizability, are cross-sectional in nature or do not assess social risk holistically across SDOH domains. Available SDOH and clinical risk factor data in large population-based databases are under-utilized for pSRS development. Recent advances in machine learning and artificial intelligence present unprecedented opportunities for SDOH integration and assessment in real-world data, with implications for pSRS development and validation for both clinical and healthcare utilization outcomes.

Summary

pSRS presents unique opportunities to potentially improve traditional “clinical” models of CVD risk prediction. Future efforts should focus on fully utilizing available SDOH data in large epidemiological databases, testing pSRS efficacy in diverse population subgroups, and integrating pSRS into real-world clinical decision support systems to inform clinical care and advance cardiovascular health equity.

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Data Availability

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Authors and Affiliations

  1. Center for Cardiovascular Computational Health and Precision Medicine (C3-PH), Houston Methodist, Houston, TX, 77030, USA

    Zulqarnain Javed & Harun Kundi

  2. Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, 77030, USA

    Zulqarnain Javed, Harun Kundi, Anoop Titus & Hassaan Arshad

  3. Houston Methodist Academic Institute, Houston, TX, 77030, USA

    Zulqarnain Javed

  4. Baylor College of Medicine, Houston, TX, USA

    Ryan Chang

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Contributions

ZJ conceptualized the manuscript, performed initial literature review, wrote the main manuscript text, created the first manuscript draft and lead manuscript revisions and editing for final submission. HK contributed to manuscript writing and review. RC contributed to development of Figure 2, performed literature review and assisted with manuscript writing/editing and review. HA reviewed the manuscript and assisted with internal revisions and editing for final submission. AT contributed to manuscript writing and review.

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Correspondence to Zulqarnain Javed.

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Javed, Z., Kundi, H., Chang, R. et al. Polysocial Risk Scores: Implications for Cardiovascular Disease Risk Assessment and Management. Curr Atheroscler Rep 25, 1059–1068 (2023). https://doi.org/10.1007/s11883-023-01173-4

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