New heart disease risk score outperforms existing test

July 08, 2009

An independent external validation of QRISK® -- a new score for predicting a person's risk of heart disease -- has shown that it performs better than the existing test and should be recommended for use in the United Kingdom by the National Institute for Health and Clinical Excellence (NICE).

The University of Nottingham and leading healthcare systems supplier EMIS worked together, through the not-for-profit partnership QResearch, to develop the ground-breaking formula which has been strongly endorsed in new research published in the British Medical Journal.

Researchers from the University of Oxford have recommended its widespread use across the UK in place of the more commonly-used Framingham equation.

Professor Julia Hippisley-Cox of The University of Nottingham's Division of Primary Care, said: "We are delighted to receive another strong endorsement of the value of QRISK in assessing the risk of heart disease in the UK population. We believe this formula has the potential to save many thousands of lives, by helping clinicians to more accurately predict those at risk of developing cardiovascular disease -- the nation's biggest killer. It will arm doctors with all the information they need to decide how best to target patients with preventative measures such as lifestyle advice and cholesterol-lowering treatments."

Soon every patient's record will contain an automatically calculated heart risk score allowing GPs to identify and target those at greatest risk.

NICE currently recommends that doctors use a modified version of the long established Framingham score to identify who should be offered statin treatment to reduce their risk of heart disease over the next 10 years.

However, in 2007, the BMJ published research showing that the new QRISK® score was a more accurate measure of how many UK adults are at risk of developing heart disease and which adults are most likely to benefit from treatment compared with the Framingham model. Now, two independent experts have compared the performance of the two scores for predicting the 10 year cardiovascular disease risk in over one million UK patients.

They tracked the progress of 1.07 million patients registered at 274 general practices in England and Wales for up to 12 years after first diagnosis of cardiovascular disease. All participants were aged between 35 and 74 at the start of the study.

The 56 per cent of GPs in the UK who use EMIS clinical records systems can already access the QRISK2 formula, which has been embedded in their systems.

EMIS Managing Director Sean Riddell said: "We are pleased to confirm that all EMIS GPs can now benefit from QRISK, and we would like to thank all those GPs who contributed anonymous patient data to support the development of this vital clinical tool."

Other clinical systems providers are able to access QRISK through a software development kit that has been designed to ensure the safe and accurate use of the formula. The QRISK software is also available for further academic research and teaching and personal use.

QRISK can be found at www.qrisk.org

The QRISK research was undertaken using the QResearch anonymised primary care database at The University of Nottingham in collaboration with the University of Edinburgh, Bristol PCT and St Mary's School of Medicine and Dentistry, London.
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Notes to editors: The University of Nottingham is ranked in the UK's Top 10 and the World's Top 100 universities by the Shanghai Jiao Tong (SJTU) and Times Higher (THE) World University Rankings.

More than 90 per cent of research at The University of Nottingham is of international quality, according to RAE 2008, with almost 60 per cent of all research defined as 'world-leading' or 'internationally excellent'. Research Fortnight analysis of RAE 2008 ranks the University 7th in the UK by research power. In 27 subject areas, the University features in the UK Top Ten, with 14 of those in the Top Five.

The University provides innovative and top quality teaching, undertakes world-changing research, and attracts talented staff and students from 150 nations. Described by The Times as Britain's "only truly global university", it has invested continuously in award-winning campuses in the United Kingdom, China and Malaysia. Twice since 2003 its research and teaching academics have won Nobel Prizes. The University has won the Queen's Award for Enterprise in both 2006 (International Trade) and 2007 (Innovation -- School of Pharmacy), and was named 'Entrepreneurial University of the Year' at the Times Higher Education Awards 2008.

Nottingham was designated as a Science City in 2005 in recognition of its rich scientific heritage, industrial base and role as a leading research centre. Nottingham has since embarked on a wide range of business, property, knowledge transfer and educational initiatives (www.science-city.co.uk) in order to build on its growing reputation as an international centre of scientific excellence. The University of Nottingham is a partner in Nottingham: the Science City.

More than 500 EMIS LV practices, representing around nine million patients, regularly contribute to the database, and over two million of these patients are included in the QRISK dataset. www.qresearch.org

The QRISK2 software was developed in collaboration with ClinRisk Ltd, a medical software company that produces algorithms for clinical use. More information is available at www.emis-online.com/products/QRisk.

More information is available from Professor Julia Hippisley-Cox on +44 (0)115 846 6915, Julia.hippisley-cox@nottingham.ac.uk; or Emma Dickinson on +44 (0)20 7383 6529 or +44 (0)7825 118107, EDickinson@bma.org.uk; or Libby Howard at EMIS on 07879 446277, libby@lhpr.uk.com or Lindsay Brooke, Media Relations Manager, on +44 (0)115 951 5751, lindsay.brooke@nottingham.ac.uk

University of Nottingham

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