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Agreement Among Cardiovascular Disease Risk Calculators

Agreement Among Cardiovascular Disease Risk Calculators Epidemiology and Prevention G. Michael Allan, MD; Faeze Nouri, MD; Christina Korownyk, MD; Michael R. Kolber, MD, MSc; Ben Vandermeer, MSc; James McCormack, PharmD Background—Use of cardiovascular disease risk calculators is often recommended by guidelines, but research on consistency in risk assessment among calculators is limited. Method and Results—A search of PubMed and Google was performed. Five clinicians selected 25 calculators by independent review. Hypothetical patients were created with the use of 7 risk factors (age, sex, smoking, blood pressure, high-density lipoprotein, total cholesterol, and diabetes mellitus) dichotomized to high and low, generating 2 patients (128 total). These patients were assessed by each calculator by 2 clinicians. Risk estimates (and assigned risk categories) were compared among calculators. Selected calculators were from 8 countries, used 5- or 10-year predictions, and estimated either cardiovascular disease or coronary heart disease. With the use of 3 risk categories (low, medium, and high), the 25 calculators categorized each patient into a mean of 2.2 different categories, and 41% of unique patients were assigned across all 3 risk categories. Risk category agreement between pairs of calculators was 67%. This did not improve when analysis was limited to just the 10-year cardiovascular disease calculators. In nondiabetics, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Circulation Wolters Kluwer Health

Agreement Among Cardiovascular Disease Risk Calculators

McCormack, James
Circulation , Volume 127 (19) – May 1, 2013
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Copyright
© 2013 American Heart Association, Inc.
ISSN
0009-7322
eISSN
1524-4539
DOI
10.1161/CIRCULATIONAHA.112.000412
pmid
23575355
Publisher site
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Abstract

Epidemiology and Prevention G. Michael Allan, MD; Faeze Nouri, MD; Christina Korownyk, MD; Michael R. Kolber, MD, MSc; Ben Vandermeer, MSc; James McCormack, PharmD Background—Use of cardiovascular disease risk calculators is often recommended by guidelines, but research on consistency in risk assessment among calculators is limited. Method and Results—A search of PubMed and Google was performed. Five clinicians selected 25 calculators by independent review. Hypothetical patients were created with the use of 7 risk factors (age, sex, smoking, blood pressure, high-density lipoprotein, total cholesterol, and diabetes mellitus) dichotomized to high and low, generating 2 patients (128 total). These patients were assessed by each calculator by 2 clinicians. Risk estimates (and assigned risk categories) were compared among calculators. Selected calculators were from 8 countries, used 5- or 10-year predictions, and estimated either cardiovascular disease or coronary heart disease. With the use of 3 risk categories (low, medium, and high), the 25 calculators categorized each patient into a mean of 2.2 different categories, and 41% of unique patients were assigned across all 3 risk categories. Risk category agreement between pairs of calculators was 67%. This did not improve when analysis was limited to just the 10-year cardiovascular disease calculators. In nondiabetics,

Journal

Circulation – Wolters Kluwer Health

Published: May 1, 2013

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