Prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records.
<h4>Objective</h4>To provide quantitative evidence for systematically prioritising individuals for full formal cardiovascular disease (CVD) risk assessment using primary care records with a novel tool (eHEART) with age- and sex- specific risk thresholds.<h4>Methods and analysis<...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0292240 |
| _version_ | 1797667872763281408 |
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| author | Ryan Chung Zhe Xu Matthew Arnold David Stevens Ruth Keogh Jessica Barrett Hannah Harrison Lisa Pennells Lois G Kim Emanuele DiAngelantonio Ellie Paige Juliet A Usher-Smith Angela M Wood |
| author_facet | Ryan Chung Zhe Xu Matthew Arnold David Stevens Ruth Keogh Jessica Barrett Hannah Harrison Lisa Pennells Lois G Kim Emanuele DiAngelantonio Ellie Paige Juliet A Usher-Smith Angela M Wood |
| author_sort | Ryan Chung |
| collection | DOAJ |
| description | <h4>Objective</h4>To provide quantitative evidence for systematically prioritising individuals for full formal cardiovascular disease (CVD) risk assessment using primary care records with a novel tool (eHEART) with age- and sex- specific risk thresholds.<h4>Methods and analysis</h4>eHEART was derived using landmark Cox models for incident CVD with repeated measures of conventional CVD risk predictors in 1,642,498 individuals from the Clinical Practice Research Datalink. Using 119,137 individuals from UK Biobank, we modelled the implications of initiating guideline-recommended statin therapy using eHEART with age- and sex-specific prioritisation thresholds corresponding to 5% false negative rates to prioritise adults aged 40-69 years in a population in England for invitation to a formal CVD risk assessment.<h4>Results</h4>Formal CVD risk assessment on all adults would identify 76% and 49% of future CVD events amongst men and women respectively, and 93 (95% CI: 90, 95) men and 279 (95% CI: 259, 297) women would need to be screened (NNS) to prevent one CVD event. In contrast, if eHEART was first used to prioritise individuals for formal CVD risk assessment, we would identify 73% and 47% of future events amongst men and women respectively, and a NNS of 75 (95% CI: 72, 77) men and 162 (95% CI: 150, 172) women. Replacing the age- and sex-specific prioritisation thresholds with a 10% threshold identify around 10% less events.<h4>Conclusions</h4>The use of prioritisation tools with age- and sex-specific thresholds could lead to more efficient CVD assessment programmes with only small reductions in effectiveness at preventing new CVD events. |
| first_indexed | 2024-03-11T20:20:51Z |
| format | Article |
| id | doaj.art-dc14972651d348468bce3aa8adda2bb4 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-11T20:20:51Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-dc14972651d348468bce3aa8adda2bb42023-10-03T05:31:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01189e029224010.1371/journal.pone.0292240Prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records.Ryan ChungZhe XuMatthew ArnoldDavid StevensRuth KeoghJessica BarrettHannah HarrisonLisa PennellsLois G KimEmanuele DiAngelantonioEllie PaigeJuliet A Usher-SmithAngela M Wood<h4>Objective</h4>To provide quantitative evidence for systematically prioritising individuals for full formal cardiovascular disease (CVD) risk assessment using primary care records with a novel tool (eHEART) with age- and sex- specific risk thresholds.<h4>Methods and analysis</h4>eHEART was derived using landmark Cox models for incident CVD with repeated measures of conventional CVD risk predictors in 1,642,498 individuals from the Clinical Practice Research Datalink. Using 119,137 individuals from UK Biobank, we modelled the implications of initiating guideline-recommended statin therapy using eHEART with age- and sex-specific prioritisation thresholds corresponding to 5% false negative rates to prioritise adults aged 40-69 years in a population in England for invitation to a formal CVD risk assessment.<h4>Results</h4>Formal CVD risk assessment on all adults would identify 76% and 49% of future CVD events amongst men and women respectively, and 93 (95% CI: 90, 95) men and 279 (95% CI: 259, 297) women would need to be screened (NNS) to prevent one CVD event. In contrast, if eHEART was first used to prioritise individuals for formal CVD risk assessment, we would identify 73% and 47% of future events amongst men and women respectively, and a NNS of 75 (95% CI: 72, 77) men and 162 (95% CI: 150, 172) women. Replacing the age- and sex-specific prioritisation thresholds with a 10% threshold identify around 10% less events.<h4>Conclusions</h4>The use of prioritisation tools with age- and sex-specific thresholds could lead to more efficient CVD assessment programmes with only small reductions in effectiveness at preventing new CVD events.https://doi.org/10.1371/journal.pone.0292240 |
| spellingShingle | Ryan Chung Zhe Xu Matthew Arnold David Stevens Ruth Keogh Jessica Barrett Hannah Harrison Lisa Pennells Lois G Kim Emanuele DiAngelantonio Ellie Paige Juliet A Usher-Smith Angela M Wood Prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records. PLoS ONE |
| title | Prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records. |
| title_full | Prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records. |
| title_fullStr | Prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records. |
| title_full_unstemmed | Prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records. |
| title_short | Prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records. |
| title_sort | prioritising cardiovascular disease risk assessment to high risk individuals based on primary care records |
| url | https://doi.org/10.1371/journal.pone.0292240 |
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