The efficacy of proposed adjusted statin dosing schedules, such as intermittent dosing, should be studied with respect to both adherence and patient-oriented outcomes. Studies should verify the washout period that is frequently employed and prospectively evaluate the theoretical reduction in statin-induced myopathy with vitamin D supplementation. F. Prospective Comparative Study of Risk Prediction Strategies Among intermediate-risk populations for whom there is less certainty regarding the risk-benefit ratio of statins, some have advocated for tests that further refine risk. To date, the best candidate for such further risk stratification is CAC scoring using ultrafast computed tomography, which has been shown to improve the AUC for diagnosis by about 5% and result in a net reclassification of about 15 20% of patients. While more patients will be identified to be at risk for an event, CAC scoring will also falsely label seven patients at high risk for a coronary event for every true high risk patient identified. Only prospective studies that directly compare risk assessment strategies (conventional risk assessment and CAC scoring compared to conventional risk assessment only) as the basis for treatment decisions among primary prevention patients will truly answer this question. Such studies have been proposed and designed but involve very large populations (n=30,000) and a prohibitive cost.[148] G. Prospective Comparison of Risk Calculators in Varied Populations The use of electronic medical records (EMR) within large organizations (e.g., VHA, MHS) creates an opportunity to create large prospective data sets. One opportunity is for the EMR to calculate risk scores and longitudinally track patients. These large data sets would help determine the overall accuracy of risk calculators and the effect of gender, ethnicity, and other factors on these risk estimates. H. Pragmatic, Evidence-based Dietary Studies Studies of dietary interventions are problematic because of adherence and monitoring issues. 