Lack of social health determinants on risk prediction tools for cardiovascular disease: A systematic review of systematic reviews.

Cardiovascular diseases (CVD) are common non-communicable diseases (1). There are several CVD risk-assessment tools, but these tools require adaptation and validation to other contexts than they were developed (2). CVD risk assessment is part of routine clinical care, but there is no clear information about the estimation of the benefits of each one of the risk-assessment tools over others. CVDs are closely related to social determinants (SD) –“circumstances in which people are born, grow, live, work, and the systems put in place to deal with illnesses"" (3–5)– and there is a need to consider those determinants into the CVD risk assessment (6). Objectives: (i) to identify systematic reviews (SR) about comparisons of CVD risk prediction tools, in terms of discrimination, calibration, and reclassification performance; and (ii) to assess if any of the risk prediction tools, from those SR, uses SD as predictor variables.