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New QRISK model identified patients in need for intervention
Hippisley-Cox J. BMJ. 2010;doi:10.1136/bmj.c6624.
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The QResearch database, a new QRISK model designed to estimate lifetime risk of CVD, identified patients in need of intervention at a younger age than a 10-year QRISK2 score.
“Although other studies have reported methods to estimate 30-year or lifetime risk, ours is the first to estimate lifetime risk of CVD based on contemporaneous U.K. data from primary care,” the researchers wrote.
The study included patients aged 30 to 84 years from 563 general practices in England and Wales who were without CVD and were not taking statins. The derivation dataset included 2,343,759 patients, and the validation dataset included 1,267,159 patients.
Among those in the validation dataset, lifetime risk for the 50th percentile was 31%, 39% for the 75th, 50% for the 90th and 57% for the 95th percentile. Additionally, for the 10% of patients in this dataset classified at highest risk with QResearch or QRISK, only 18,385 (14.5%) were at high risk on both measures.
Further analysis revealed that patients identified as high risk in the QResearch model were more likely to be younger, male, have a positive family history of premature CHD and be from ethnic minority groups than those identified with the 10-year QRISK2 score.
Questions that should be answered with future research, the investigators wrote, include whether early intervention vs. later intervention in people with a high lifetime risk but low 10-year risk will have a greater clinical benefit and whether people at low absolute risk will value long-term treatments with little short-term gain.
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