Poorthuis MHF, Sherliker P, Morris DR, et al. - Although risk scores have been developed to identify the individuals at increased risk of asymptomatic carotid stenosis (ACS), thereby enabling targeted screening, scope for refinement of prediction by adding additional predictors has been identified in previous external validation. Hence, researchers sought to develop a novel risk score for moderate (≥ 50%) and severe (≥ 70%) ACS using data from 596,469 individuals who attended screening clinics. Following were identified as predictors of ≥ 50% and ≥ 70% ACS: age, gender, current smoking, diabetes mellitus, prior stroke/transient ischemic attack, coronary artery disease, peripheral arterial disease, blood pressure, and blood lipids. Relative to previous models, the novel risk model showed better performance and predicted the prevalence of ACS reliably. Targeted screening among the highest decile of predicted risk led to identification of nearly 40% of all cases with ≥ 50% ACS. Initiation or intensification of cardiovascular risk management in detected cases may aid in lowering both carotid related ischemic strokes and myocardial infarctions.