Assessing the public health relevance of a risk factor

In a recent series of high impact public health publications, the c-index was used as measure of prediction to assess the public health relevance of a risk factor. I demonstrate that the c-index is an inferior measure as compared to the classical epidemiologic measures most commonly employed for risk prediction and public health assessment such as disease incidence, relative risk (RR) and population-attributable risk (PAR). I recommend using the latter measures when assessing the public health relevance of a risk factor.