A ‘blog’ produced by the National Prescribing Centre (NPC) and posted on its website (NPCi) discusses QRISK – a new cardiovascular disease risk scoring system that was developed specifically for use in the UK. A validation study for this system was published recently in the journal ‘Heart’; the study abstract and the calculator itself can be accessed via the links above.
The blog discusses the calculator and the validation study, and discusses its place in comparison with the Framingham method in predicting cardiovascular risk in the general population. The author of the blog concludes (taken directly from the website):
“Health professionals should be aware of the ongoing debate, and also that Framingham-based tools may over-predict CV risk in some sections of the UK population, but not others, such as those in high risk groups (e.g. socio-economically deprived, people of South Asian descent, those with a family history of CV events, etc). Even with these caveats, as the draft NICE full guideline on lipid modification says - estimates of CVD risk derived from equations are not an exact science but are better than clinical judgment alone for the estimation of CVD risk. Of course, health professionals need to take into account patient circumstances and wishes. It would be foolish to have an iron rule that (whatever tool is used) someone with a 19.9% predicted risk can never receive prophylaxis, but someone with a 20.1% risk must always receive prophylaxis. The most important thing is to correctly use a validated tool – be it Framingham, ASSIGN or QRISK as a basis for discussion with patients and not to treat on the basis of individual risk factors.”
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