Project background

In 2010, the National Institute for Health and Care Excellence (NICE) ceased recommending any single risk scale (1) for the assessment of cardiovascular risk in primary prevention due to a lack of evidence that the previously recommended Framingham-Anderson scale was more predictive than other existing scales. This was amended in the 2014 NICE guideline in favour of the QRISK2 risk assessment tool that was developed based on the UK population (2). However, QRISK2 is updated annually (most recently in 2015) and it has a lack of long-term validation data, compared to other risk scales, such as the Framingham scales. Furthermore, during the period 2010 – 2014, health professionals were left to their own discretion as to which cardiovascular health measurement scale to use and this is evident in clinical practise today, where clinicians have a tendency to use the scales with which they are most familiar.

Although many prospective studies have been conducted to validate and compare different cardiovascular risk assessment scales, there is still a wide array of scales available and the results of such studies are inconclusive as to which scale is the most robust. While the usefulness of existing scales is likely to vary considerably across relevant patient groups defined according to a range of factors, including geographical location, it seems impractical to conduct similar prospective studies to cover every such group that a healthcare professional may encounter. Nevertheless, the demands on clinicians to keep abreast with developments in the above field are considerable. This challenge needs to be addressed through provision of an accessible platform for reviewing and updating evidence for the utility and relative validity of individual risk assessment scales in primary prevention for a range of study populations. The Cardiovascular Health Measurement Scales Wiki is designed to address this need and to provide an exemplar for similar work involving such scales beyond the stage of primary prevention.

References
(1) Mayor S. Doctors no longer have to use Framingham equation to assess heart disease risk, NICE says. BMJ 2010;340:c1774.
(2) National Institute for Health and Clinical Excellence. Cardiovascular disease: risk assessment and reduction, including lipid modification. London: NICE. 2014.