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For adapting the PREDICT equations to Australia, M\u0101ori, Pacific Islander, Middle Eastern, Latin American, and African people were excluded because of demographic differences between the two countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>The New Zealand PREDICT equations (general and diabetes\u2010specific versions) were recalibrated for Australia, based on differences between Australia and New Zealand in CVD\u2010specific mortality by age group and sex. Body mass index (BMI), ethnic background, and family history of CVD were omitted as variables in the general equation; BMI was retained in the diabetes\u2010specific equation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Risk prediction outcomes: first CVD\u2010specific hospitalisation or death. Model performance measures: calibration of the modified equations, assessed by plotting mean 5\u2010year predicted risk against observed 5\u2010year risk; model discrimination, assessed with the Harrell <jats:italic>C<\/jats:italic> statistic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The modified New Zealand cohort for deriving the general AUS\u2010PREDICT risk equation included 308\u2009478 people (134\u2009137 women, 43.5%); the modified cohort for deriving the diabetes\u2010specific risk equation included 29\u2009219 people with type 2 diabetes (13\u2009246 women, 45.3%). For the general equation, predicted and observed CVD risks were closely aligned across risk deciles; discrimination was good for both women (<jats:italic>C<\/jats:italic>\u2010statistic, 0.75; 95% confidence interval [CI], 0.74\u20130.76) and men (<jats:italic>C<\/jats:italic>\u2010statistic, 0.74; 95% CI, 0.73\u20130.74). For the diabetes\u2010specific equation, predicted and observed CVD risks were also closely aligned across risk deciles; discrimination was acceptable for both women (<jats:italic>C<\/jats:italic>\u2010statistic, 0.73; 95% CI, 0.71\u20130.75) and men (<jats:italic>C<\/jats:italic>\u2010statistic, 0.70; 95% CI, 0.68\u20130.71).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The internal validity of the new Australian CVD risk algorithm, recommended in the 2023 Australian CVD risk assessment and management guidelines, is good and has been recalibrated for use in Australia. The updated risk calculator is a landmark advance in the assessment of CVD risk in Australian primary care.<\/jats:p><\/jats:sec>","DOI":"10.5694\/mja2.52718","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T06:48:17Z","timestamp":1751438897000},"page":"197-204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Development and calibration of the 2023 Australian cardiovascular disease risk prediction equations: a model updating study"],"prefix":"10.5694","volume":"223","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0855-9872","authenticated-orcid":false,"given":"Ellie","family":"Paige","sequence":"first","affiliation":[{"name":"QIMR Berghofer Medical Research Institute  Brisbane QLD"},{"name":"National Centre for Epidemiology and Population Health Australian National University  Canberra ACT"},{"name":"The University of Queensland  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Banks AM","sequence":"additional","affiliation":[{"name":"National Centre for Epidemiology and Population Health Australian National University  Canberra ACT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuehan","family":"Zhang","sequence":"additional","affiliation":[{"name":"National Centre for Epidemiology and Population Health Australian National University  Canberra ACT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anushka","family":"Patel","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health  Sydney NSW"},{"name":"Sydney Medical School the University of Sydney  Sydney NSW"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Woodward","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health  Sydney NSW"},{"name":"The George Institute for Global Health Imperial College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9474-258X","authenticated-orcid":false,"given":"Natalie","family":"Raffoul","sequence":"additional","affiliation":[{"name":"National Heart Foundation of Australia  Sydney NSW"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garry","family":"Jennings","sequence":"additional","affiliation":[{"name":"National Heart Foundation of Australia  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney T","family":"Jackson","sequence":"additional","affiliation":[{"name":"The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"e_1_2_9_1_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw106"},{"key":"e_1_2_9_2_1","first-page":"e596","article-title":"2019\u00a0ACC\/AHA guideline on the primary prevention of cardiovascular disease: a\u00a0report\u00a0of\u00a0the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"140","author":"Arnett DK","year":"2019","journal-title":"Circulation"},{"key":"e_1_2_9_3_1","unstructured":"New Zealand Ministry of Health.Cardiovascular disease risk assessment and management for primary care.2018.https:\/\/www.tewhatuora.govt.nz\/assets\/Publications\/Cardiovascular\u2010Publications\/cardiovascular\u2010disease\u2010risk\u2010assessment\u2010management\u2010primary\u2010care\u2010feb18\u2010v4_0.pdf(viewed Jan 2025)."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CD9.0000000000000025"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001191"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00572-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30664-0"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022367"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab309"},{"key":"e_1_2_9_10_1","unstructured":"National Vascular Disease Prevention Alliance.Guidelines for the management of absolute cardiovascular disease risk.2012. 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