Cardiovascular risk calculators: understanding differences and realising economic implications.
In recent years, the concept of "global cardiovascular risk assessment" has grown in interest for its role in primary prevention of cerebro-cardiovascular diseases. Interventions for reducing the risk of relapse for persons with past history of these diseases are well agreed-on. On the contrary, the risk status of persons without such a history varies greatly, and this variability implies a range in the intensity of interventions. In several countries, guidelines for general practitioners have been diffused about pharmaceutical prescriptions in presence of various risk degrees. In particular, in Italy, a governmental drug management commission has established that statins, the most used cholesterol lowering medicines, can be refunded by the National Healthcare System only if prescribed to hyper-cholesterol patients with a global risk greater than 20%. The question is: how to calculate the risk? We performed a review of both the web and the literature and we found a lot of different "risk calculators". By means of a simulation study, we showed that these tools, when applied to the same person, may lead to very different results. We estimated the economic impact of using one or another calculator.
Quaglini
Silvana
S
Department of Computer Science and Systems, University of Pavia, Italy.
Stefanelli
Mario
M
Boiocchi
Lorenzo
L
Campari
Fabio
F
Cavallini
Anna
A
Micieli
Giuseppe
G
D000465:Algorithms; D000924:Anticholesteremic Agents / Q000191:economics / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008432:Mathematical Computing; D011336:Probability; D018570:Risk Assessment / Q000191:economics / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012984:Software
D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents