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Reviewing the use and quality of machine learning in developing clinical prediction models for cardiovascular disease
  1. Simon Allan1,
  2. Raphael Olaiya2,
  3. Rasan Burhan3
  1. 1 Manchester Medical School, The University of Manchester, Manchester, UK
  2. 2 UCL Centre for Artificial Intelligence, University College London, London, UK
  3. 3 St George's Healthcare NHS Trust, St George's Healthcare NHS Trust, London, UK
  1. Correspondence to Mr Simon Allan, The University of Manchester, Manchester M14 6AS, UK; simon.allan{at}


Cardiovascular disease (CVD) is one of the leading causes of death across the world. CVD can lead to angina, heart attacks, heart failure, strokes, and eventually, death; among many other serious conditions. The early intervention with those at a higher risk of developing CVD, typically with statin treatment, leads to better health outcomes. For this reason, clinical prediction models (CPMs) have been developed to identify those at a high risk of developing CVD so that treatment can begin at an earlier stage. Currently, CPMs are built around statistical analysis of factors linked to developing CVD, such as body mass index and family history. The emerging field of machine learning (ML) in healthcare, using computer algorithms that learn from a dataset without explicit programming, has the potential to outperform the CPMs available today. ML has already shown exciting progress in the detection of skin malignancies, bone fractures and many other medical conditions. In this review, we will analyse and explain the CPMs currently in use with comparisons to their developing ML counterparts. We have found that although the newest non-ML CPMs are effective, ML-based approaches consistently outperform them. However, improvements to the literature need to be made before ML should be implemented over current CPMs.

  • cardiology
  • epidemiology
  • general medicine (see Internal Medicine)
  • public health
  • statistics & research methods

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  • Contributors SA: conception and design of study, acquisition of data, analysis and/or interpretation of data, drafting the manuscript, approval of submission. RO: analysis and/or interpretation of data, revising the manuscript critically for important intellectual content, approval of submission. RB: analysis and/or interpretation of data, revising the manuscript critically for important intellectual content, approval of submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.