New score is needed to predict risk of coronary heart disease

doi:10.1136/bmj.324.7347.1217

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Peter Brindle, Wellcome training fellow in health services research, department of social medicine (peter.brindle@bristol.ac.uk),
Tom Fahey, senior lecturer in general practice, division of primary health care,
Shah Ebrahim, professor in epidemiology of ageing, department of social medicine

University of Bristol, Bristol BS8 2PR

EDITOR—McManus et al show the difficulties inherent in using currently available risk scoring systems for cardiovascular disease, with only moderate agreement between methods.1 They also show the methods' relatively low accuracy when compared with independently calculated Framingham risk estimates.

Much of the inaccuracy was due to a lack of risk factor information in case records and use of risk scoring in people with diagnosed cardiovascular disease, who should be considered at high risk and treated accordingly. As in previous comparison studies, the Framingham …