Hippisley-Cox J et al. (2007) Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. BMJ 335: 136

A team of British researchers have developed and validated a new cardiovascular disease risk algorithm (QRISK) that is suited to the UK population and performs as well as established algorithms.

A variety of tools are available for calculating the risk of cardiovascular disease. The American Framingham algorithm is the most widely used in the UK, but tends to overestimate risk in European populations.

Hippisley-Cox and colleagues performed a prospective, open cohort study using data collected from a primary care population to derive and validate a new algorithm, and compare its performance with that of the Framingham algorithm and the new Scottish ASSIGN equations.

The QRISK algorithm was derived using a cohort of 1.28 million patients aged 35–74 years from 318 practices across the UK, who did not have diabetes or existing cardiovascular disease. The algorithm was then validated in a cohort of 0.61 million patients from 160 UK practices.

The 10-year risks of a cardiovascular event in the validation cohort were 6.60% and 9.28% for women and men, respectively. The overall risk was overestimated by a factor of 1.35 using the Framingham algorithm, by a factor of 1.36 using the ASSIGN equations, and by a factor of 1.004 using the new QRISK algorithm.

The authors conclude that this new algorithm will provide risk estimates more appropriate to the UK population and will help to ensure that patients most in need of treatment are correctly identified. This tool will, however, need to be further validated in other populations.