![]() ![]() I suspect the switch from Framingham, although slower than many thought, is inevitable.īut there's one very interesting and important message from the past few years of research into this issue. But I think the evidence suggests the balance is in favour of QRISK. I'd say utility is a major factor, so you should probably choose the one you feel is more user-friendly. NICE was seen by some as ducking the issue when it announced in March 2010 that Framingham was no longer the tool of choice and that GPs should use whichever was available locally. The one thing that will finally decide this issue is the unequivocal recommendation of one over the other in a major UK guideline – something we're still waiting for. QRISK relies on age and sex-based averages for missing data which are then interpolated – by as much as 60% for HDL-C, for example. Although the QRISK dataset is British and more recent, it is less complete than Framingham's.Risk is adjusted for variables not included in Framingham – like deprivation and current treatment for hypertension.It has been subject to UK validation using a separate research database.QRISK scores are calibrated to a UK population, and a much more recent one than Framingham.Many specialists have serious doubts that QRISK should automatically take its place.įor this article it would be useful to look at the advantages and disadvantages of the new kid on the block – QRISK – compared with the old hand, Framingham. 1īut Framingham has proved surprisingly tenacious, and not just because it's firmly lodged in the back of the BNF. We should also not forget ASSIGN – a risk score based on Scottish data that has been endorsed by the Scottish Intercollegiate Guidelines Network. So when the QRESEARCH database – of over 10 million UK patients in 550 practices – was used to develop QRISK, many predicted it would quickly supersede Framingham. The Framingham Heart Study is a long-term, ongoing cardiovascular study of the residents of one US town which began in 1948 and is now on its third generation of participants.īut even in 1998 – when the score was launched in its current form – the limitations of applying the risk score to European populations were recognised. The Framingham risk score is based on a massive dataset. GP and hospital practitioner in cardiology Dr Matt Hughes outlines five aspects of risk management that have been subject to recent debate ![]()
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