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QRISK still in frame for cardiovascular screening

By Nigel Praities

GPs face having to use two different scoring systems to assess cardiovascular risk, with the Department of Health considering ignoring the new NICE guidance for its upcoming screening programme.

As Pulse revealed last week, the institute's final guidance on lipid lowering recommended a modified version of Framingham to assess CVD risk, reversing a provisional decision to opt for the UK-based QRISK score.

But Pulse has learned that the department has been in private discussions with QRISK researchers about using the risk score for its cardiovascular screening programme, due to be launched next year.

Professor Julia Hippisley-Cox, QRISK researcher and professor of primary care at the University of Nottingham, said the department and heart tsar Dr Roger Boyle were keen to see how QRISK could address health inequalities. ‘We have to get the risk score right. Using Framingham would miss women in deprived areas and ethnic minorities.'

Unlike QRISK, NICE guidance does not adjust by social deprivation, although Framingham risk is to be multiplied by 1.5 for those with a family history and 1.4 times for south Asian men.

But Dr Gerald Partridge, a cardiology GPSI in Keighley, West Yorkshire, said running two systems would be ‘a real headache'.

Dr Terry McCormack, a GP in Whitby and chair of the Primary Care Cardiovascular Society, said the department was consulting on the plans and was unlikely to diverge from the NICE advice.

He said: ‘It is looking at embedded risk scoring, but I don't think it will go with QRISK.'

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