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Review Article | DOI: https://doi.org/10.31579/2641-0419/503
1Department of Cardiology, Mody Harvard Cardiac Institute & Research Centre- Krishna Super Specialty Hospital, Bathinda, Punjab, India.
2Department of Cardiology, Aster Hospital, Mankhool, Dubai, Al Quasis, UAE.
3Department of Internal Medicine, Resident Doctor, Trinity Health Hospital, 36475 Five Mile Rd, Livonia, Michigan, 48335, USA.
4Department of Cardiology, Mody Harvard Cardiac Institute & Research Centre- Krishna Super Specialty Hospital, Bathinda, Punjab, India.
5Department of Cardiology, Spectrum Medical Center and Burjeel Royal Hospital, Al Ain, UAE.
*Corresponding Author: Rohit Mody, Department of Cardiology, Mody Harvard Cardiac Institute & Research Centre- Krishna Super Specialty Hospital, Bathinda, Punjab, India.
Citation: Rohit Mody, Debabrata Dash, Bhavya Mody, Umanshi Dash, Rajeev Gupta, (2025), Atherosclerotic Cardiovascular Disease (ASCVD) Risk Scoring: Present Landscape and Future Directions for Precision Prevention, J Clinical Cardiology and Cardiovascular Interventions, 8(11); DOI:10.31579/2641-0419/503
Copyright: © 2025, Rohit Mody. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 30 June 2025 | Accepted: 25 August 2025 | Published: 02 September 2025
Keywords: atherosclerosis; preventive programs; risk scores
Atherosclerotic cardiovascular disease (ASCVD) has emerged as the major cause of global mortality and morbidity. Risk of ASCVD can be assessed by using various conventional risk assessment tools like SCORE2, and Pooled Cohort Equations (PCE) which are associated with various drawbacks. This article demonstrates the conventional models limitations and explores a precision-based and multidimensional approach for prediction of risk. We review the integration of coronary artery calcium (CAC) scoring, novel biomarkers (e.g., hsCRP, Lp(a), ApoB) and polygenic risk scores (PRS) alongside the emerging role played by environmental exposures and social determinants of health (SDOH). Recent advancements in artificial intelligence (AI)-including federated learning, deep learning and natural language processing- are providing real-time and dynamic estimation of risk by assessing multi-model data from omics, imaging and electronic health records platform. Ethical consideration and implementation challenges linked with application of these integrative model in clinical practice are also discussed in this. ASCVD prevention future lies in adopting adaptive and personalized options guided by AI enabled stratification of risk, with great focus on clinical utility, interpretability and equity. This evolving paradigm hold huge clinical advantage for more accurate assessment, earlier therapeutic intervention and improved clinical outcomes in patients across diverse populations.
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of morbidity and mortality worldwide, accounting for nearly one-third of all global deaths [1]. Accurate risk assessment is the cornerstone of preventive cardiology, guiding the allocation of pharmacologic and lifestyle interventions to those most likely to benefit. Over the past two decades, risk prediction models such as the Pooled Cohort Equations (PCE) and SCORE2 have become integral to clinical guidelines, enabling clinicians to estimate 10-year and lifetime ASCVD risk based on traditional risk factors including age, sex, blood pressure, cholesterol levels, smoking status, and diabetes [2,3].
Instead of widespread clinical utilizations, these models are associated with various drawbacks. Under-performance of these model has been noticed in certain ethnic groups, specifically in patients preset with severe inflammatory conditions and those present with atypical risk profiles [4]. Furthermore, emerging risk enhancers like high sensitivity C-reactive protein, lipoprotein(a) and apolipoprotein B or the severity and duration of diabetes are considered in conventional scoring methods. [5]. Sex-specific factors (e.g., premature menopause, preeclampsia) and family history are also insufficiently integrated, leading to risk misclassification, particularly in women and younger adults [6].
Recent advances in biomarker research and genomics have catalyzed the development of next-generation risk stratification tools. Coronary artery calcium (CAC) scoring, for example, provides direct quantification of subclinical atherosclerosis and significantly refines risk estimates in intermediate-risk individuals [7]. Inflammatory biomarkers, particularly hsCRP, have demonstrated independent predictive value and therapeutic relevance, as evidenced by trials targeting inflammation to reduce ASCVD events [8].
Moreover, polygenic risk scores (PRS) aggregate the effects of numerous genetic variants, identifying individuals at high lifetime risk even in the absence of traditional risk factors [9]. However, the clinical utility of PRS is currently limited by a lack of validation in non-European populations and challenges in integrating genetic data into routine care [10]. Distribution spectrum of polygenic risk scores (PRS) in individuals with different risk scores is demonstrated in figure 1
Table 1: Incremental Value of Biomarkers and Imaging in ASCVD Risk Prediction [18].
Emerging strategies utilizes machine learning and artificial intelligence (AI) to produce multidimensional data from imaging, biomarkers, genomics and electronic health records, offering the huge promise of more individualized and accurate risk assessment [11]. Furthermore, incorporating social determinants of health (SDOH)-like education, neighbourhood environment and socioeconomic status has been demonstrated to address health disparities and model performance [12].
As the field shifts towards prevention in a precise manner, the integration of social, biological, clinical and genetic data is poised to transform assessment of risk of ASCVD. This evolving paradigm major objective is to deliver more effective, personalized, equitable therapeutic options for prevention of cardiovascular disease, ultimately reduced the ASCVD global burden.
2.1. Calibration and Discrimination in Diverse Populations
A quite significant role is played by conventional ASCVD risk scores, such as SCORE2 and PCE in guiding preventive strategies. However, significant variations have been observed in their discrimination and calibration across various socioeconomic, geographic and ethnic groups. For instance, studies reveal that the PCE tends to overestimate risk in contemporary U.S. cohorts, particularly among White populations, while underestimating risk in South Asian, Indigenous, and certain Black populations [13]. SCORE2, although recalibrated for European subpopulations, still demonstrates limited accuracy in Central and Eastern European countries, where ASCVD incidence remains high [3].
These discrepancies majorly originate from the original deviation cohorts, which often associated with lack of representation from minority or high-risk groups, and from secular changes in epidemiology of ASCVD due to improved management of risk factor and therapeutic strategies. In addition to this, 0.65 and 0.75 discrimination ability of these models has been measured by C-statistic, indicating only moderate assessment power. In individuals present with atypical risk profiles, such as those with HIV or premature menopause or chronic inflammatory diseases, this moderate performance is quite problematic whose risk assessment is systematically underestimated by traditional models.
2.2. Omission of Non-Traditional and Emerging Risk Factors
Current risk calculators majorly focus on blood pressure, smoking status, diabetes, sex and age, omitting non-traditional risk factors that have been robustly associated to ASCVD. Notably, the duration and control of diabetes, chronic kidney disease, autoimmune conditions, and markers of chronic inflammation are not routinely incorporated. This omission is consequential, as individuals with chronic inflammatory diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus) have a 1.5- to 2-fold increased risk of ASCVD, independent of traditional risk factors [14].
Individuals with inherited risk, such as those present with familial hypercholesterolemia, can’t be identified by using standard calculators due to absence of genetic predisposition and family history, who may present with normal profile of lipid but with significant lifetime risk. [15]. Clinical utility of these models in real-world, heterogeneous populations is further limited due to lack of integration of SDOH-including access to health care facilities, education, income and neighbourhood deprivation.
2.3. Temporal and Dynamic Risk Assessment Deficiencies
A critical limitation of current ASCVD risk scores is their static nature. Most models provide a one-time risk estimate, typically over a 10-year horizon, without accounting for changes in risk factor control, medication adherence, or the emergence of new risk modifiers over time. This approach fails to capture the dynamic trajectory of risk, particularly in younger individuals or those with evolving comorbidities. Emerging evidence supports the use of repeated risk assessment and incorporation of time-updated variables to better reflect the true risk continuum [16]. 10-years prediction risk of ASCVD in patients by pooled cohort equations is demonstrated in figure 2A. Predicted risk of ASCVD risk over 10 years is demonstrated in figure 2B.
Figure 2A: 10-years prediction risk of ASCVD in patients by pooled cohort equations.
Figure 2B: Predicted risk of ASCVD risk over 10 years.
Figure 2C: Comparison of ACC/AHA predicted risk and observed rates over 10 years.
Moreover, traditional calculators do not account for the cumulative burden of risk factors, such as the duration of hypertension or hyperlipidemia, which has been shown to confer higher risk than point-in-time measurements. This limitation is specifically relevant in younger adults, where instead of low short-term risk estimates lifetime risk may be huge. Figure 2C demonstrate comparison of ACC/AHA predicted risk and observed rates over 10 years.
3.1. Role of Novel Biomarkers in Risk Refinement
The circulating biomarkers addition has been suggested to potentiate risk of ASCVD prediction, specifically in individuals at intermediate risk. hsCRP is the most extensively validated inflammatory marker, with elevated levels independently predicting ASCVD events even in the setting of low high-sensitivity C-reactive protein [17]. Other emerging biomarkers include lipoprotein(a) [Lp(a)], apolipoprotein B (ApoB), and high-sensitivity troponin, each associated with residual risk not captured by traditional metrics.
Despite their promise, the incremental value of these biomarkers in risk reclassification remains modest. For example, the addition of hsCRP to
the PCE improves the C-statistic by only 0.01–0.03. The clinical utility of routine biomarker measurement is therefore debated, with guidelines recommending their use primarily in cases of clinical uncertainty or intermediate risk.
3.2. CAC Scoring as a Risk Modifier
Non-invasive imaging, particularly CAC scoring, has emerged as a powerful tool for individualized risk assessment. CAC quantifies subclinical atherosclerosis and provides incremental prognostic information beyond traditional risk factors. In the Multi-Ethnic Study of Atherosclerosis, individuals with a CAC score of zero had a 10-year ASCVD event rate of <2>100 had substantially higher event rates [18].
CAC scoring is specifically useful in reclassifying individuals present with intermediate or borderline risk, guiding the intensification or initiation of statin therapy. However, its clinical utility is limited by cost, access and concerns regarding exposure to radiation and it remain underestimated in younger adults and women, where non-calcified plaques may be preferred. Incremental value of biomarkers and imaging in ASCVD risk prediction are shown in table 1 [18].
| Tool/Marker | Incremental C-static | Clinical Utility | Limitations |
| hsCRP | +0.01-0.03 | Intermediate risk reclassification | Modest improvement, cost |
| Lp(a) | +0.01 | Identifies genetically mediated risk | Limited assay standardization |
| ApoB | +0.01 | Residual risk in statin-treated | Not universally available |
| CAC Score | +0.05-0.10 | Strongest for risk reclassification | Access, radiation, cost |
Table 1: Incremental Value of Biomarkers and Imaging in ASCVD Risk Prediction
†hsCRP: high-density C-Reactive Protein; Lp(a): Lipoprotein(a); ApoB: Apolipoprotein B; CAC: Coronary Artery Calcium
4.Social and Environmental Determinants in Risk Prediction
4.1. Socioeconomic and Psychosocial Factors
A growing body of evidence underscores the impact of SDOH on ASCVD risk. Factors such as income, education, neighborhood deprivation, food insecurity, and access to healthcare significantly influence both the incidence and outcomes of cardiovascular disease [19]. Psychosocial stressors, including depression and social isolation, have also been linked to increased ASCVD events, independent of traditional risk factors.
Instead of their significance, SDOH are rarely utilized in risk prediction models. Latest advancements, such as the progression of the neighborhood-level and Social Deprivation Index, have suggested discrimination and improved calibration when integrated with clinical models. SDOH incorporation into risk assessment of ASCVD is quite important for advancing health equity and targeted therapeutic interventions to undeserved and high-risk populations.
4.2. Environmental Exposures
Environmental exposures, including climate-related factors, noise and air pollution, are characterized as major contributors to risk of ASCVD. Huge exposure to fine particulate matter (PM2.5) is linked with 10-20% rise in risk of cardiovascular events per 10 µg/m³ increment [20]. However, in standard risk calculators, these exposures are not captured currently, representing a missed chance for risk stratification in a comprehensive manner.
5.1. Electronic health record (EHR)-Driven and Multi-Modal Risk Prediction
Recent advancements in machine learning (ML) and AI potentiate the risk prediction models development that leverage multi-omic biomarkers, imaging data and large-scale EHRs. In comparison to conventional risk scoring methods in early-phase studies, these models have suggested superior discrimination and calibration. For example, incorporation of 400 variables in ML-based models has achieved a C-statistic of 0.80–0.85 for prediction of ASCVD, outperforming the SCORE2 and PCE.
Risk estimates can be dynamically update by AI-driven strategies due to availability of new data, facilitating time-updated, and personalized risk trajectories. Furthermore, AI techniques are being established to potentiate patient and clinician understanding of risk drivers and promoting shared decision-making [21].
5.2. Future Directions: Integrative and Equitable Risk Assessment
The future of prediction of ASCVD risk exist in the integration of social, genetic, biomarker and clinical data within AI-enabled platforms. Such multidimensional models have the capacity to deliver highly preventive, predictive and personalized care, while addressing disparities in assessment of risk. Ongoing risk includes ensuring equitable model performance, algorithm transparency and data privacy across wide populations [22].
6.Integration of Inflammation, Genetics, And Social Determinants In Risk Prediction
6.1. Interplay of Inflammatory Pathways and Genomic Risk in ASCVD
The convergence of genetic susceptibility and severe inflammation is highly characterized as a central driver of risk of ASCVD risk, beyond what is identified by conventional risk factors. While prior content has addressed the omission of non-traditional risk factors and the role of PRS, this section uniquely focuses on the biological and mechanistic interplay between inflammatory pathways and genomic risk, and their implications for risk prediction.
Chronic low-grade inflammation, as evidenced by elevated biomarkers such as hsCRP, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), is both a cause and consequence of atherogenesis [23]. Genome-wide association studies have identified variants in loci related to inflammatory signaling (e.g., IL6R, CRP, NLRP3) that modulate both systemic inflammation and ASCVD risk [24]. Notably, individuals with high polygenic risk for coronary artery disease (CAD) and concomitant elevated hsCRP exhibit a synergistically increased risk of major adverse cardiovascular events, suggesting that the co-occurrence of pro-inflammatory genotypes and phenotypes amplifies atherothrombotic risk [25].
Furthermore, findings of Mendelian randomization studies have suggested that genetically assessed rise in CRP and Il-6 causally rise in risk of ASCVD, suggesting a direct mechanistic association. This insight has increased the dual-risk models progression, integration of inflammatory biomarkers and PRS for accurate stratification of individuals present with huge risk for incident ASCVD, specifically those who may get clinical benefit from anti-inflammatory therapies [26]. Comparative risk of ASCVD by combined inflammatory and genetic status is demonstrated in table 2 [25,26].
| Risk Group | 10-Year ASCVD Event Rate (%) | Relative Risk vs. Reference |
| Low PRS + Low hsCRP | 4.1 | 1.0 |
| High PRS + Low hsCRP | 7.8 | 1.9 |
| Low PRS + High hsCRP | 8.2 | 2.0 |
| High PRS + High hsCRP | 14.3 | 3.5 |
Table 2: Comparative Risk of ASCVD by Combined Inflammatory and Genetic Status
†ASCVD: Atherosclerosis Cardiovascular Disease; PRS: Polygenic Risk Score; hsCRP: high-density C-Reactive Protein.
6.2. Social Genomics: The Intersection of Social Determinants and Molecular Risk
Distinct from prior sections on socioeconomic and psychosocial factors, this section explores the emerging field of social genomics, which investigates how SDOH interact with genetic and epigenetic mechanisms to influence ASCVD risk. Social adversity—including chronic stress, discrimination, and neighborhood deprivation—has been shown to induce pro-inflammatory gene expression profiles (the "conserved transcriptional response to adversity"), characterized by upregulation of NF-κB–dependent inflammatory genes and downregulation of antiviral responses [27].
Epigenome-wide association studies reveal that adverse SDOH can modify DNA methylation patterns at loci implicated in vascular inflammation and lipid metabolism, thereby modulating the penetrance of genetic risk [28]. For instance, individuals present with huge polygenic risk for CAD who also faces huge social deprivation suggested accelerated incidence of ASCVD, independent of conventional risk factors [29].
These findings suggest a "double jeopardy" model, wherein the genetic predisposition and adverse social environments intersection is responsible for disproportionate elevation in risk of ASCVD. Incorporation of social genomics into various risk prediction models may potentiate calibration and facilitate targeted therapeutic interventions in huge-risk, socially disadvantaged populations [30].
6.3. Multi-Omics Integration for Precision Risk Prediction
While previous sections have demonstrated the individuals biomarkers and genetic scores additions, this section addresses the multi-omics data integration-encompassing proteomics, genomics, metabolomics and transcriptomics-into prediction of ASCVD RISK. Multi-omics approaches enable the identification of molecular signatures that reflect both inherited and acquired risk, providing a comprehensive view of the atherogenic process [31].
Recent prospective cohort studies have demonstrated that multi-omics risk scores, constructed from panels of plasma proteins (e.g., growth differentiation factor-15 [GDF-15], myeloperoxidase [MPO]), metabolites (e.g., trimethylamine N-oxide [TMAO]), and genetic variants, outperform traditional clinical models in predicting incident ASCVD. For example, a C-statistic of 0.83 is achieved for 5-years ASCVD events on incorporation of a proteomics risk score > 50 proteins, in comparison to 0.72 for the PCEs [32].
Moreover, application of machine learning algorithms to mutli-omics datasets can uncover recent risk clusters, potentiate the novel endophenotypes assessment and personalized preventive options. The integration of multi-omics with EHR and SDOH data represents a critical frontier in the evolution of precision ASCVD prevention. Incremental predictive value of multi-omics models is shown in table 3 [32].
| Model Type | C-Static (5-Year ASCVD) | Net Reclassification Improvement (%) |
| Pooled Cohort Equatins | 0.72 | - |
| Genomics + Proteomics | 0.81 | +18 |
| Multi-Omics (All Layers) | 0.83 | +25 |
Table 3: Incremental Predictive Value of Multi-Omics Models
†ASCVD: Atherosclerosis Cardiovascular Disease.
6.4. Implementation Science: Bridging Precision Risk Models and Clinical Practice
Distinct from prior discussions of AI and machine learning, this section addresses the challenges and strategies for implementing integrative risk models—incorporating inflammation, genetics, and SDOH—into routine cardiovascular prevention. Despite the promise of multi-dimensional risk scores, real-world uptake remains limited by barriers including data interoperability, clinician education, and patient acceptability
Implementation science frameworks, such as the Consolidated Framework for Implementation Research, are being applied to optimize the integration of precision risk tools into clinical workflows [33].
Key strategies include:
Findings of pilot studies demonstrate that the integrative risk models utilization can improve control of risk factor, patient satisfaction and statin initiation rates, specifically in high-risk, underserved populations. However, intense randomized implementation trials are required to quantify the clinical outcomes of ASCVD and health equity.
6.5. Ethical, Legal, and Social Implications (ELSI) of Integrative Risk Prediction
While previous reports have not addressed this dimension, the rapid evolution of integrative risk prediction raises critical ELSI. The use of genetic, inflammatory, and SDOH data in risk stratification introduces new challenges related to privacy, consent, data ownership, and potential discrimination.
Key ELSI considerations include:
Addressing these ELSI issues is needed to ensure that integrative risk prediction advancement translate into socially, trustworthy and equitable cardiovascular risk prevention.
7.1. AI-Driven Risk Prediction: Beyond Traditional Variables
While previous sections have demonstrated multi-model and EHR-driven risk assessment, this section will focus on AI algorithms next generations that leverage deep learning, natural language processing and federated learning in which unstructured data sources are utilized to extract nuanced risk signals. Recent advances in deep neural networks have enabled the integration of longitudinal EHR data, imaging, and even clinical notes to predict ASCVD events with improved discrimination and calibration, surpassing conventional regression-based models [37]. For example, convolutional neural networks applied to raw electrocardiogram (ECG) data have demonstrated the ability to predict future myocardial infarction risk independently of traditional risk factors [38].
Federated learning-a privacy-preserving AI approach- enables the robust risk model training across various institutions without sharing patient data sensitively, thus addressing concerns about representativeness and data privacy. Natural language processing further augment risk assessment by extracting relevant behavioral determinants and social determinants, which are often omitted from structural datasets. Comparison of AI-driven and traditional ASCVD risk models is demonstrated in table 4 [37,38]. AI applications in assessment of ASCVD risk are demonstrated in figure 3
| Model Type | Data Inputs | C-Statistic (Range) | Unique Features |
| Pooled Cohort Equations | Demographics, Lipids, BP, Diabetes, Smoking | 0.66-0.77 | Population-based, limited variables |
| Deep Learning (HER + Imaging | HER, imaging, labs, unstructured notes | 0.78-0.87 | Learns complex patterns, dynamic |
| Federated Learning | Multi-centre HER, imaging | 0.80-0.86 | Privacy-preserving, scalable |
| ECG-based AI | Raw ECG signals | 0.80-0.88 | Detects subclinical risk, real-time |
Table 4: Comparison of AI-Driven and Traditional ASCVD Risk Models
†PCE: Pooled Cohort Equations; BP: Blood Pressure; ECG: Electrocardiogram; AI: Artificial Intelligence.
Figure 3: AI applications in assessment of ASCVD risk.
7.2. Dynamic, Time-Updated Risk Estimation
Distinct from the static, baseline risk estimates provided by current calculators, emerging AI-enabled models are capable of generating dynamic, time-updated risk trajectories.
With the objective to recalibrate an individual risk of ASCVD in real time, these models assimilate new laboratory data, lifestyle data, medication changes and clinical events on routine basis. This strategy is specifically useful for patients with evolving risk profiles such as those with new-onset hypertension, incident diabetes or inflammatory biomarkers changes.
Moreover, dynamic risk estimation supports adaptive prevention strategies, allowing clinicians to intensify or de-escalate therapies based on the most current risk assessment. For example, a patient whose risk increases due to rising hsCRP or low=density lipoprotein-cholesterol (LDL-C) despite therapy may warrant earlier initiation of anti-inflammatory or lipid-lowering agents [8]. Static vs dynamic risk estimation in ASCVD prevention is demonstrated in table 5.
| Feature | Static Models (PCE, SCORE2) | Dynamic AI Models |
| Risk Calculation Frequency | Once (baseline) | Repeated, real-time |
| Data Inputs | Baseline Clinical/lab data | Time-varying, multi-modal |
| Adaptation to New Events | No | Yes |
| Clinical Utility | Population-level | Personalized, adaptive |
Table 5: Static vs. Dynamic Risk Estimation in ASCVD Prevention.
†PCE: Pooled Cohort Equations; AI: Artificial Intelligence.
7.3. Multidimensional Risk Models: Integrating Omics, Imaging, and SDOH
While previous sections have discussed multi-omics integration and social genomics, this section emphasizes the convergence of multi-layered data streams—genomics, proteomics, metabolomics, advanced imaging, and social determinants—within unified risk models. These multidimensional models are designed to capture the heterogeneity of ASCVD risk across diverse populations and to identify high-risk individuals who may be missed by traditional tools.
For instance, the integration of PRS with CAC scoring and SDOH metrics has demonstrated superior risk stratification compared to any single domain alone [25]. Proteomic risk panels, incorporating dozens of circulating proteins, further refine risk prediction, particularly in intermediate-risk individuals [32]. Data domains in multidimensional ASCVD risk models are shown in table 6 [25]
| Domain | Example Variables | Incremental Value |
| Genomics | PRS, monogenic variants | Early-life risk, family history |
| Proteomics | hsCRP, GDF-15, MPO, Lp(a) | Inflammation, plaque instability |
| Imaging | CAC, carotid plaque, vascular age | Subconical atherosclerosis |
| SDOH | Income, education, neighborhood, stress | Healthy equity, access |
| Clinical | BP, lipids, diabetes, smoking | Baseline risk |
Table 6: Data Domains in Multidimensional ASCVD Risk Models
†PRS: Polygenic Risk Score; hsCRP: high-sensitivity C-Reactive Protein; GDF: Grow/Differentiation Factor; MPO: Myeloperoxidase; Lp(a): Lipoprotein(a); SDOH: Social Determinants of Health; BP: Blood Pressure.
7.4. Precision Prevention: Targeted Interventions Based on Individualized Risk
The paradigm of precision prevention moves beyond risk prediction to actionable, individualized intervention. AI-augmented risk models enable the identification of distinct risk endotypes—such as inflammation-dominant, lipid-dominant, or genetically driven ASCVD—each of which may benefit from tailored preventive strategies [26]. For example, individuals with high PRS and elevated Lp(a) may be prioritized for early PCSK9 inhibitor therapy, while those with persistent inflammation
despite statins may benefit from anti-inflammatory agents such as colchicine or canakinumab [8].
In addition, multidimensional risk models facilitate shared decision-making by providing patients with personalized risk trajectories and the projected benefit of specific interventions. Digital health platforms and mobile applications are increasingly being used to deliver individualized risk feedback, promote adherence, and monitor response to therapy in real time [22]. Precision prevention strategies by risk endotype are shown in table 7 [26].
| Risk Endotype | Key Features | Targeted Intervention |
| Inflammation- dominant | High hsCRP, GDF-15, MPO | Anti-inflammatory therapy |
| Lipid- dominant | High LDL-C, Lp(a), ApoB | Statins, PCSK9i, Lp(a) inhibitors |
| Genetic | High PRS, monogenic variants | Early screening, aggressive Rx |
| SDOH-driven | Low SES, high stress, poor access | Community interventions, navigation |
| Mixed | Multiple domains elevated | Multimodal, team-based care |
Table 7: Precision Prevention Strategies by Risk Endotype
†hsCRP: high-sensitivity C-Reactive Protein; GDF: Grow/Differentiation Factor; MPO: myeloperoxidase; LDL-C; Low-Density Lipoprotein-C; Lp(a) Lipoprotein(a); ApoB: Apolipoprotein; PRS: Polygenic Risk Score; SDOH; Social Determination of Health; SES: Socioeconomic.
7.5. Real-World Implementation and Model Validation
While implementation science and ELSI have been discussed previously, this section focuses on the technical and operational challenges in deploying multidimensional AI risk models at scale. Rigorous external validation across diverse populations is essential to ensure generalizability and to mitigate algorithmic bias. Prospective studies, such as the PREVENTABLE and My Gene Rank trials, are evaluating the clinical utility, acceptability, and cost-effectiveness of AI-enabled and genomics-informed risk assessment in routine practice.
Major key operational consideration includes interoperability with patient engagement, explainable AI interfaces development, existing HER systems and clinician education to support shared-decision making. Furthermore, continuous post-departmental monitoring is needed to ensure equity, assess performance drift and adapt to evolving clinical guidelines. Solutions and challenges in implementing multidimensional risk models are demonstrated in table 8 [21]. Atherosclerotic cardiovascular disease risk scoring and present landscape & future directions for precision prevention are demonstrated in Central Illustration.
| Challenge | Solution/Strategy |
| Data interoperability | Standardized data formats, APIs |
| Algorithmic bias | Diverse training datasets, fairness auditing |
| Clinician adoption | Education, decision support tools |
| Patient engagement | Digital risk communication, apps |
| Model drift | Continuous monitoring, recalibration |
Table 8: Challenges and Solutions in Implementing Multidimensional Risk Models
Central Illustration: Atherosclerotic Cardiovascular Disease (ASCVD) Risk Scoring:
Present Landscape and Future Directions for Precision Prevention.
ASCVD risk prediction has evolved from traditional, population-based models—such as the PCE and SCORE2—to a new era of precision prevention that integrates genomics, inflammation, advanced biomarkers, imaging, and SDOH. A valuable foundation for population-level prevention has been provided by conventional risk scores, but their clinical utility is limited due to various drawback such as under performance in diverse populations, moderate predictive power and omission of significant risk modifiers like genetic susceptibility, socioeconomic factors and chronic inflammation.
Risk stratification in individuals has been improved with the addition of various biomarkers (e.g., hsCRP, Lp(a)), CAC scoring, and PRS), specifically in individuals with intermediate-risk and atypical risk profiles. In addition to this, need for multidimensional integrative models has been limited due to interconnection between inflammatory and genetic pathway, as well as adverse effect of social environment on molecular risk.
The future of prevention of ASCVD exist in the clinical utilization of dynamic, multidimensional and AI-enabled risk models that assimilate SDOH, imaging, clinical and omics date to deliver adaptive, equitable and personalized care. These recent advancements potentiate predictive accuracy and ability to assess distinct risk endotypes and guide targeted therapeutic interventions-such as early lipid-lowering drugs, anti-inflammatory therapies or community-based options-tailored to individual profiles risk. However, successful implementation into clinical field will need rigorous validation, attention to equity and ethical concerns and strict implementation science to ensure that across all population, precision prevention benefits are realized.
The lead author of the review article is Dr Rohit Mody. Dr Debabrata Dash, Dr Bhavya Mody, Dr Umanshi Dash and Dr Rajeev Gupta had equal and substantial contributions in the formation of this review article. They were involved in conceptualization, data curation, formal analysis, resources, software, validation, visualization, writing - original draft, Writing, review & editing
I thank Mr. Rohit for assisting me to finalize the review article. Figures are edited by Mr. Jiwan Singh.
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Ethical approval was not required since it is an accepted procedure
Written consent has been obtained to publish the review article from the guardian. The consent copy is available with the authors and ready to be submitted if required.
All authors have nothing to disclose.
All authors have nothing to disclose.
There is no funding or financial conflicts of interest to disclose.
There is no funding or financial conflicts of interest to disclose.
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As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Giselle Pentón-Rol.
