{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T05:25:56Z","timestamp":1771392356118,"version":"3.50.1"},"reference-count":88,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Stroke is the second leading cause of death and the third leading cause of disability worldwide. We performed a systematic review and meta-analysis of multivariable models applicable to the prediction of incident stroke in community cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Ovid Medline and Embase were searched for studies related to stroke and prediction models from inception to 3 November 2025. Measures of discrimination were extracted and pooled by Bayesian meta-analysis, with heterogeneity assessed through a 95% prediction interval (PI). Risk of bias was assessed using the Prediction model Risk Of Bias Assessment Tool and certainty in effect estimates by Grading of Recommendations, Assessment, Development and Evaluation. Forty-one studies met the inclusion criteria, describing 80 prediction models, with two (R-FSRS and Basic IS) eligible for meta-analysis, including 969 514 participants. Both R-FSRS (summary c-statistic 0.714, 95% CI 0.681\u20130.747) and Basic IS (0.709, 95% CI 0.647\u20130.769) showed acceptable discrimination performance. Risk of bias was high in 66% of models, and both models showed reduced performance when excluding development cohorts and studies at high risk of bias (R-FSRS, 0.667, 95% CI 0.604\u20130.727; Basic IS 0.701; 95% CI 0.583\u20130.807). Only 43% of studies reported calibration, and no model underwent clinical utility analysis or a clinical impact study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Many models have been derived for stroke prediction, however, they are rarely externally validated, and studies are limited by a high risk of bias, poor reporting of calibration and a lack of clinical utility analysis or prospective validation. Thus, the evidence base is insufficient to translate these models to clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztaf147","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T13:09:04Z","timestamp":1765458544000},"source":"Crossref","is-referenced-by-count":0,"title":["Prediction models for incident stroke in the community: a systematic review and meta-analysis of predictive performance"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3859-7809","authenticated-orcid":false,"given":"Mohammad","family":"Haris","sequence":"first","affiliation":[{"name":"Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds , 6 Clarendon Way, Leeds, LS2 9DA ,","place":["UK"]},{"name":"Leeds Institute of Data Analytics, University of Leeds , Clarendon Way, Leeds, LS2 9NL ,","place":["UK"]},{"name":"Department of Cardiology, Leeds Teaching Hospitals NHS Trust , Great George Street, Leeds, LS1 3EX ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Romer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Airedale NHS Foundation Trust , Keighley ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3680-4180","authenticated-orcid":false,"given":"Tanina","family":"Younsi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Leeds Teaching Hospitals NHS Trust , Great George Street, Leeds, LS1 3EX ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6093-599X","authenticated-orcid":false,"given":"Jianhua","family":"Wu","sequence":"additional","affiliation":[{"name":"Wolfson Institute of Population Health, Queen Mary University of London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harriet","family":"Larvin","sequence":"additional","affiliation":[{"name":"Wolfson Institute of Population Health, Queen Mary University of London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Hull York Medical School, University of York , York ,","place":["UK"]},{"name":"Academic Cardiovascular Unit, South Tees NHS Foundation Trust, James Cook University Hospital , Middlesbrough ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6965-1109","authenticated-orcid":false,"given":"Alan","family":"Cameron","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio F","family":"Romiti","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza - University of Rome , Rome ,","place":["Italy"]},{"name":"Liverpool Centre for Cardiovascular Science, at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital , Liverpool ,","place":["United Kingdom"]},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University , Aalborg ,","place":["Denmark"]},{"name":"Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit, Medical University of Bialystok , Bialystok ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9895-9356","authenticated-orcid":false,"given":"Ramesh","family":"Nadarajah","sequence":"additional","affiliation":[{"name":"Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds , 6 Clarendon Way, Leeds, LS2 9DA ,","place":["UK"]},{"name":"Leeds Institute of Data Analytics, University of Leeds , Clarendon Way, Leeds, LS2 9NL ,","place":["UK"]},{"name":"Department of Cardiology, Leeds Teaching Hospitals NHS Trust , Great George Street, Leeds, LS1 3EX ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4732-382X","authenticated-orcid":false,"given":"Chris P","family":"Gale","sequence":"additional","affiliation":[{"name":"Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds , 6 Clarendon Way, Leeds, LS2 9DA ,","place":["UK"]},{"name":"Leeds Institute of Data 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