QRISK2 gets more support

The heart disease risk score QRISK2 is more accurate at identifying people in the UK at high risk of cardiovascular disease than the Framingham risk equation, newly published research has concluded.

Statisticians from Oxford University compared QRISK2 with its predecessor QRISK1 and with the version of Framingham previously recommended by the National Institute for Health and Clinical Excellence. They found that QRISK2 was more accurate than the Framingham equation.

Until recently, NICE recommended use of the Framingham equation. However, earlier this year it changed its advice to recommend that local health communities make their own choice of which score to use.

The researchers’ analysis, published on BMJ online, looked at 1.58m patients registered with 365 GP practices in the UK.

It found that the Framingham equation overestimated the ten year risk of CVD, while more accurate results were delivered by the QRISK1 and QRISK2 calculators.

The QRISK scores have been developed in a joint not-for-profit initiative by Nottingham University and healthcare IT system suppliers EMIS, using its database of 39m patients.

The researchers said the development and internal testing of QRISK, together with their own external validation, meant the score had been assessed on 3.9m patients, which was one of the largest groups of patients used to test and validate a risk score before its implementation in clinical practice.

The researchers said the Framingham score was built on a relatively small group of 5,573 patients based on a single town in the US between 1968 and 1975.

They added: “The superior performance of the QRISK risk scores is not surprising as both QRISK risk scores were developed (and internally and externally validated) on large cohorts of general practice patients in the United Kingdom, the population for which the risk predictions were targeted and designed.”