Framingham-based tools to calculate the global risk of coronary heart disease
- Stacey SheridanAffiliated withDivision of General Medicine and Clinical Epidemiology, UNC Hospital Email author
- , Michael PignoneAffiliated withDivision of General Medicine and Clinical Epidemiology, UNC Hospital
- , Cynthia MulrowAffiliated withDivision of General Medicine, University of Texas Health Sciences Center
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PURPOSE: To examine the features of available Framingham-based risk calculation tools and review their accuracy and feasibility in clinical practice.
DATA SOURCES: medline, 1966–April 2003, and the google search engine on the Internet.
TOOL AND STUDY SELECTION: We included risk calculation tools that used the Framingham risk equations to generate a global coronary heart disease (CHD) risk. To determine tool accuracy, we reviewed all articles that compared the performance of various Framingham-based risk tools to that of the continuous Framingham risk equations. To determine the feasibility of tool use in clinical practice, we reviewed articles on the availability of the risk factor information required for risk calculation, subjective preference for 1 risk calculator over another, or subjective ease of use.
DATA EXTRACTION: Two reviewers independently reviewed the results of the literature search, all websites, and abstracted all articles for relevant information.
DATA SYNTHESIS: Multiple CHD risk calculation tools are available, including risk charts and computerized calculators for personal digital assistants, personal computers, and web-based use. Most are easy to use and available without cost. They require information on age, smoking status, blood pressure, total and HDL cholesterol, and the presence or absence of diabetes. Compared to the full Framingham equations, accuracy for identifying patients at increased risk was generally quite high. Data on the feasibility of tool use was limited.
CONCLUSIONS: Several easy-to-use tools are available for estimating patients’ CHD risk. Use of such tools could facilitate better decision making about interventions for primary prevention of CHD, but further research about their actual effect on clinical practice and patient outcomes is required.
DISCLOSURE: Drs. Sheridan and Pignone have participated in the development of Heart-to-Heart, one of the risk tools evaluated within. They have also received speaking and consulting fees from Bayer, Inc. Bayer, Inc. has licensed the Heart-to-Heart tool.
Key wordsrisk assessment coronary heart disease Framingham Heart Study
- Framingham-based tools to calculate the global risk of coronary heart disease
Journal of General Internal Medicine
Volume 18, Issue 12 , pp 1039-1052
- Cover Date
- Print ISSN
- Online ISSN
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- risk assessment
- coronary heart disease
- Framingham Heart Study
- Industry Sectors
- Author Affiliations
- 1. Division of General Medicine and Clinical Epidemiology, UNC Hospital, 5039 Old Clinic Building, 27599-7110, Chapel Hill, NC
- 2. Division of General Medicine, University of Texas Health Sciences Center, San Antonio, Tex