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Government considers QRISK for patient CVD risk tool

By Nigel Praities

The Government is shunning NICE guidance and exploring the possibility of using an alternative risk score to Framingham for its Lifechecks scheme, Pulse has learned.

NICE recommends GPs use a modified version of Framingham for assessing cardiovascular risk, but the Department of Health is piloting two other risk scores – Finrisk and the UK-based QRISK – alongside Framingham.

Trials are to take place in various locations – such as a pharmacy in Guy's and St Thomas' Hospital – and the scheme will be rolled out from next year to ‘complement and reinforce' vascular screening.

The fact ministers are conducting their own pilots to compare the three risk scores, rather than simply adopting NICE guidance, will be seen as lack of confidence in the institute's controversial lipid modification guidance, released earlier this year.

But GPs are concerned a divergence between Lifechecks and general practice could undermine patient trust by handing patients two completely different risk scores.

The NHS Lifecheck scheme, set to be featured on the NHS Choices website and on terminals in pharmacies, will allow patients to enter details about their lifestyle, assess their own CVD risk and be directed to their GP if their risk is high.

Pulse revealed in May that NICE lipid modification guidance had controversially decided to back away from endorsing QRISK – which is due to be added to the EMIS system, it was announced last week - after pressure from cardiologists.

Dr Mark Davis, a member of the Primary Care Cardiovascular Society and a GP in Leeds, said consistency was important and that he was concerned about the effect NHS Lifecheck could have if it used QRISK or Finrisk.

‘It doesn't do much for confidence if a patient has been given a percentage absolute risk and a doctor comes out with a different one,' he said.

A Department of Health spokesperson said it was currently consulting with stakeholders over NHS Lifecheck, which was due for a summer 2009 launch.

‘We are examining a number of risk tools as part of developing the NHS mid-life checks programme. The NHS Mid-life LifeCheck will be piloted during early 2009 prior to national launch later in the year,' she said.

Framingham: could be snubbed in new patient CV checks Framingham: could be snubbed in new patient CV checks

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