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GPs buried under trusts' workload dump

Framingham under threat as DH re-examines risk scores

By Nigel Praities

The Government is set to ask NICE to look again at its decision to recommend Framingham ahead of QRISK as the best tool for measuring cardiovascular risk. The move could render the Department of Health's vascular screening programme out of date before it has even started.

PCTs across the country are pushing ahead with plans to screen millions of patients for cardiovascular risk from next April – using the Framingham tool.

But the DH has completed an independent validation of the evidence examined by NICE, some of which is unpublished, in order to judge whether the institute was right in choosing Framingham ahead of the UK-based QRISK algorithm.

The DH review was conducted by an independent academic team at the University of Oxford and is believed to favour QRISK.

Advisers for NICE told Pulse there was now a strong case for the institute to reconsider the case for the QRISK algorithm.

Dr Tom Marshall, a senior lecturer in public health at the University of Birmingham and a member of the development group for the NICE lipid modification guideline, said the evidence base for QRISK was improving all the time: ‘Since publication of the [NICE] guideline, the QRISK situation has moved on. QRISK is improving and it has the potential to be more appropriate for a UK population. It is probably where the future lies.'

Pulse revealed last month that the Government was piloting QRISK, among other risk scores, for its Lifechecks scheme that will run in tandem with the vascular screening initiative.

A NICE spokesperson said it had not seen the study but would consider any new evidence.

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