Intended for healthcare professionals


Improving the accuracy of predicting cardiovascular risk

BMJ 2010; 340 doi: (Published 13 May 2010) Cite this as: BMJ 2010;340:c2334
  1. Ian Scott, director of internal medicine and clinical epidemiology
  1. 1Princess Alexandra Hospital, Ipswich Road, Brisbane, QLD, 4102, Australia
  1. ian_scott{at}

    QRISK2 supersedes Framingham as the risk prediction score of first choice

    Risk prediction tools are intended to help clinicians identify people at high risk of future disease events in whom more systematic use of preventive interventions is warranted. In formulating clinical recommendations and planning health services, professional groups and health authorities need to be aware of newly developed tools that more accurately stratify risk in the general population. In the linked study (doi:10.1136/bmj.c2442), Collins and Altman assess the performance of the QRISK2 score for predicting 10 year cardiovascular disease in an independent cohort of patients from general practice in the United Kingdom.1 The authors also compare its performance with the version of the Framingham score previously recommended by the National Institute for Health and Clinical Excellence (NICE) and QRISK1.

    Unfortunately, the use of risk prediction tools in routine clinical practice has a chequered history for several reasons. Firstly, the tools themselves are often poorly developed and inaccurate2 or have not been subject to proper external validation.3 Secondly, they may be cumbersome to use or not readily accessible in busy practice settings.4 Thirdly, whether they alter clinical decision making …

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