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IJE Advance Access originally published online on January 7, 2009
International Journal of Epidemiology 2009 38(1):231-234; doi:10.1093/ije/dyn353
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Commentary: C-reactive protein and risk prediction—moving beyond associations to assessing predictive utility and clinical usefulness

Ramachandran S Vasan1,2,3

1The Framingham Study, Boston University School of Medicine, Framingham, MA, USA. E-mail: vasan@bu.edu.
2Department of Preventive Medicine, Boston University School of Medicine, Boston, MA, USA.
3Cardiology Section, Boston University School of Medicine, Boston, MA, USA.

Accepted 4 December 2008

The first 10% of the full text of this article appears below.

The only relevant test of the validity of a hypothesis is comparison of prediction with experience

        Milton Friedman


   Introduction
 
The last three decades have seen major advances in our understanding of the pathogenesis of coronary heart disease (CHD), with substantial improvements in our management of patients at risk of disease and of those who have suffered a coronary event. The multifactorial nature of coronary disease and its evolution as a life course disease1 due to the combined influences of genetic and lifestyle-related factors are firmly accepted concepts. We no longer argue about the role of cholesterol and its components as critical mediators of the disease, nor dispute whether the occlusive thrombus in the coronary tree in a patient with a myocardial infarction antedates or follows the clinical event. However, the debates in cardiology continue to rage with a . . . [Full Text of this Article]


   Assessing the incremental predictive utility of a biomarker
 

   Assessing incremental clinical utility of biomarkers
 

   Funding
 

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