Retraction and Replacement Notice: Ekwunife O et al. on Social Risk Factors and Disparities in Advanced Cardiovascular-Kidney-Metabolic Syndrome

Category	Detail
Condition	Advanced cardiovascular-kidney-metabolic (CKM) syndrome and its association with social risk factors.
Key Mechanisms	Coding errors in CKM staging thresholds overclassified advanced CKM; corrected analyses used a 20% PREVENT risk threshold and required both normal BMI and waist circumference for CKM stage 0.
Target Population	28,184 participants in the corrected cohort; survey-weighted estimates represented 165,637,840 US individuals.
Care Setting	Population-level analysis of US adults using survey data; the notice addresses corrected classification and statistical findings, not clinical care.

The original code applied 0.2 to PREVENT risk values expressed on a 0%–100% scale, rather than the intended threshold of at least 20%.
The corrected CKM stage 0 definition required both BMI and waist circumference to be within the normal range; 34 participants without CKM stage data were excluded.
The corrected cohort included 5,879 participants with advanced CKM; weighted prevalence was 15.8%, representing 26,132,788 US adults.
The corrected findings continued to support associations between advanced CKM and several social risk factors, with differences across racial and ethnic groups and between sexes.
Statistical significance classification changed for 31 findings in the main article and 14 findings in interaction models.

The corrected analysis classified CKM stage 3 high 10-year cardiovascular disease risk using an AHA PREVENT threshold of at least 20% on the 0%–100% risk scale.
The corrected CKM stage 0 anthropometric definition required both BMI and waist circumference to be within the normal range.

A scale mismatch in threshold coding substantially overclassified CKM stage 3 and advanced CKM syndrome.
The corrected outcome classification changed the significance classification of findings in the main article and interaction models.

The corrected analysis included 28,184 participants: 22,305 classified as nonadvanced CKM and 5,879 as advanced CKM.

The notice reports no treatment or prescribing data; it describes corrected prevalence and associations with social risk factors.

The authors corrected the PREVENT threshold code to use 20 on the 0%–100% scale.
The authors corrected the CKM stage 0 code to require both anthropometric measures to be normal.
The corrected workflow excluded 34 participants without CKM stage data, resulting in a cohort of 28,184 participants.
The authors regenerated descriptive statistics, prevalence estimates, regression models, subgroup analyses, and interaction models after correcting outcome classification.

Clinical Scorecard: Retraction and Replacement Notice: Social Risk Factors and Disparities in Advanced Cardiovascular-Kidney-Metabolic Syndrome