Editorials

Risk factor scoring for coronary heart disease

BMJ 2003; 327 doi: http://dx.doi.org/10.1136/bmj.327.7426.1238 (Published 27 November 2003) Cite this as: BMJ 2003;327:1238
  1. Hans-Werner Hense (hense@uni-muenster.de), professor of clinical epidemiology
  1. Institute of Epidemiology and Social Medicine, University of Münster, D 48129, Münster, Germany

    Prediction algorithms need regular updating

    Global risk assessment has become an accepted component of clinical guidelines and recommendations in cardiovascular medicine. The aim is to provide a valid estimate of the probability of a defined cardiovascular event over a period of five or ten years in individuals free of clinical manifestations of cardiovascular disease at the time of examination. The information available for global risk assessments commonly consists of individual risk factor measurements and a basic assessment of concurrent clinical conditions. The aim of the resulting absolute level of predicted risk is to determine the intensity of clinical intervention. What do we know about the validity of the population data from which the individual risk factor measurements are derived?

    The Framingham Heart Study and the Framingham Offspring Study were the first epidemiological studies that prospectively collected population based data on the association between risk factors and the occurrence of fatal and non-fatal coronary and other cardiovascular events in a systematic and sustained …

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