Transcript Analysis and critical overview on on

Čavaljuga Semra, Ademović Enisa, Ibrahimović Lejla, Čelik Damir1, Veledar
Emir2
Institute of Epidemiology and biostatistics, Faculty of Medicine, University of Sarajevo, BiH
Emory University, Atlanta, georgia, USA
 Risk calculators are a helping tool in
quantification of risk of getting a
cardiovascular disease in a certain period of
time.
 There is no universal calculator that can be
used on an entire world population. Risk
assessment equations predict risk best in the
type of population from which they were
derived.
An aim of this study is:
 to represent characteristics of available cardiovascular
risk calculators,
 explain the crucial differences among them and facilitate
decision on which one of them to use in which cases.
Metods:
 Browsing on-line literature, available
cardiovascular risk calculators, that are used to
calculate cardiovascular risk in North America
and Europe, were analyzed.
Results and discusion:
 Risk calculator of which are used to assess risk for North
American populations (Framingham equation).
 Risk calculator of which are used to assess risk in
European populations (BNF, ASSIGN, QRISK)
From The Framingham Heart Study
CHD(MI and Coronary Death) Risk
Prediction
Enter Values Here
Risk Factor
Gender
Age
Total Cholesterol
HDL
Systolic Blood Pressure
Treatment for Hypertension {Only if
SBP>120}
Current Smoker
Units
male (m) or female (f)
years
mg/dL
mg/dL
mmHg
National Cholesterol Education
Program
Adult Treatment Panel III
(Type Over Placeholder Values in
Each Cell)
f
70
130
60
119
yes (y) or no (n)
yes (y) or no (n)
n
y
Time Frame for Risk Estimate
Your Risk (The risk score shown
is derived on the basis of an
equation. Other NCEP materials,
such as ATP III print products, use
a point-based system to calculate a
risk score that approximates the
equation-based one.)
10 years
10
0,03
3%
Notes
If value is < the minimum for the
field, enter the minimum value. If
value is > the maximum for the
field, enter the maximum value.
These functions and programs were prepared by Ralph B. D'Agostino, Sr., Ph.D. and Lisa M. Sullivan, Ph.D., Boston University and The Framingham Heart Study and Daniel Levy, M.D., Framingham Heart Study, National Heart, Lung and Blood Institute.
0.02
0.04
0.03
0.00
Your Risk Estimate,
0.05
Comparative Risks for
Same Age and Gender
0.10
0.15
0.20
0.25
Lowest = Total Chol<160, HDL>60, Optimal SBP (<120), No Trt for Htn, Non-Smoker
Low = Total Chol 160-199, HDL 50-59, Normal SBP (<130), No Trt for Htn, Non-Smoker
0.30
JBS/BNF
ASSIGN kalkulator
QRISK®2 kalkulator
 Basic differences among them are related to the time
period for which the risk is being calculated, patient’s age
range, cigarette smoking, diabetes, family history,
presence of left ventricular hypertrophy, definition of
blood cholesterol values, comorbidity, definition of blood
pressure values.
What does mean if someone has a 10 year QRisk
score of 20%?
 If someone has a 10 year QRisk score of 20% then in a
crowd of 100 people like them, on average 20 people
would get cardiovascular disease over the next 10 years.
Or put another way, they have a ‘one in five’ chance of
getting cardiovascular disease over the next 10 years.
Conclusion
 There are differences among different risk calculators; it is
the definition of cardiovascular diseases in the first place
(Original Framinghman definition, JBS definition, ASSIGN
definition…), and the risk factors included in calculation.
From the very first risk calculators, constructed after the
end of the first phase of Framingham study in 1980s, until
today, risk calculators have changed over time, in order to
reflect properly the population changes.
 It is essential to emphasize that risk calculators are
designed as an aid in clinical decision-making, and
should not in any case neglect the clinical judgement
of a patient.
Thank you!!!