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Q In different groups of patients, are Framingham risk assessments accurate for predicting cardiovascular disease (CVD) events? Do risk assessments improve health outcomes?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Cardiology ★★★★★★☆ Internal medicine ★★★★★☆☆
Medline, EMBASE/Excerpta Medica, Cochrane Controlled Trials Register (CENTRAL), CINAHL, PsycINFO, ISI Proceedings, British Library’s Electronic Table of Contents (ZETOC), bibliographies of relevant studies, and hand searches of key journals (to September 2004).
Study selection and assessment:
studies in any language that compared risk of fatal and non-fatal coronary heart disease (CHD) or CVD outcomes predicted by Framingham risk scores with observed 10 year risk, and randomised controlled trials (RCTs) that assessed the effectiveness of CV risk scores to aid primary prevention in patients predominantly free of symptomatic CVD. Studies of older risk scores not used in clinical practice and studies reporting only fatal outcomes were excluded. 27 risk assessment studies (n = 71 727, age range 30–80 y) met the …
For correspondence: Dr P Brindle, University of Bristol, Bristol, UK.
Sources of funding: UK Department of Health and Wellcome Trust.