Medicine:QRISK
| QRISK | |
|---|---|
| Medical diagnostics | |
| Purpose | prediction of cardiovascular disease |
QRISK3 (the most recent version of QRISK) is a prediction algorithm for cardiovascular disease (CVD) that uses traditional risk factors (age, systolic blood pressure, smoking status and ratio of total serum cholesterol to high-density lipoprotein cholesterol) together with body mass index, ethnicity, measures of deprivation, family history, chronic kidney disease, rheumatoid arthritis, atrial fibrillation, diabetes mellitus, and antihypertensive treatment.[1]
A QRISK over 10 (10% risk of CVD event over the next ten years) indicates that primary prevention with lipid lowering therapy (such as statins) should be considered.[2] In the UK, current National Institute for Health and Care Excellence (NICE) guidelines recommend using QRISK (as opposed to the Framingham Risk Score).[2]
The algorithm has subsequently been validated by an independent team from the Centre for Statistics in Medicine (University of Oxford) using an external dataset.[3][4][5] The results were published in the BMJ and demonstrated that QRISK performed better than Framingham [1]. www.qrisk.org is updated annually to reflect changes in populations, data quality and national guidelines (such as a change in age range over which cardiovascular risk should be assessed). The inclusion of ethnicity and deprivation in the QRISK2 algorithm is designed to help prevent widening health inequalities. The QIntervention website combines QRISK with a similar risk prediction tool (www.qdiabetes.org) to calculate risk of cardiovascular disease and type 2 diabetes. www.qintervention.org also allows clinicians to assess 'what if' scenarios i.e. how risk might change with modification of risk factors such as weight loss, stopping smoking, use of statins and better blood pressure control.[citation needed]
QRISK has also been developed further to estimate individualised lifetime risk of cardiovascular disease.[6]
See also
- Preventive medicine
- Framingham Risk Score
References
- ↑ Hippisley-Cox, J; Coupland, C; Vinogradova, Y; Robson, J; Brindle, P (2008). "Performance of the QRISK cardiovascular risk prediction algorithm in an independent UK sample of patients from general practice: a validation study". Heart 94 (1): 34–39. doi:10.1136/hrt.2007.134890. PMID 17916661. http://heart.bmj.com/content/94/1/34.full.
- ↑ 2.0 2.1 "Lipid modification (CG181): cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease". National Institute for Health and Care Excellence (NICE). July 2014. http://www.nice.org.uk/guidance/cg181/chapter/1-recommendations.
- ↑ Collins, Gary S; Altman, Douglas G (7 July 2009). "An independent external validation and evaluation of QRISK cardiovascular risk prediction: a prospective open cohort study". BMJ 339: b2584. doi:10.1136/bmj.b2584. PMID 19584409.
- ↑ Collins, Gary S; Altman, Douglas G (13 May 2010). "An independent and external validation of QRISK2 cardiovascular disease risk score: a prospective open cohort study". BMJ 340: c2442. doi:10.1136/bmj.c2442. PMID 20466793.
- ↑ Collins, Gary S; Altman, Douglas G (21 June 2012). "Predicting the 10 year risk of cardiovascular disease in the United Kingdom: independent and external validation of an updated version of QRISK2". BMJ 344: e4181. doi:10.1136/bmj.e4181. PMID 22723603.
- ↑ Hippisley-Cox, Julia; Coupland, Carol; Robson, John; Brindle, Peter (9 December 2010). "Derivation, validation, and evaluation of a new QRISK model to estimate lifetime risk of cardiovascular disease: cohort study using QResearch database". BMJ 341: c6624. doi:10.1136/bmj.c6624. PMID 21148212.
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