Every provider needs a good cardiovascular risk calculator. There were 86,641 deaths from cardiovascular disease (CVD) in the US in 2015. CVD kills more people than ALL forms of cancer combined. The evidence base is firmly established for secondary prevention of CVD with multiple medications including aspirin, and statins. The evidence for primary prevention for statins and aspirin is somewhat more controversial, but nonetheless compelling.
The American Heart Association launched the Simple 7 campaign to significantly reduce the burden of CVD by 2020. Patients can evaluate their lifestyle versus the Simple 7 recommendations here for free. In 2013, the AHA/ACC stunned many in the medical and non-medical fields with their long awaited update of the cholesterol guidelines. The guidelines created a firestorm of controversy for the “dropping” of hard targets for LDL levels and the emphasis on primary prevention of CVD using statins with the new pooled equations calculator.
Based on the 2013 lipid guidelines update, many of us stopped using the ATPIII/Framingham risk calculator and switched to the new pooled equations calculator. The AHA/ACC even released an excellent app encompassing both the pooled equations calculator and the lipid guideline called ASCVD Risk Estimator. Previously on iMedicalApps we reviewed the ASCVD Risk Estimator and found it easy to use and providing a wealth of information for both patients and providers. Since 2009, the National Health Service (NHS) in the United Kingdom (UK) has been using QRISK. This risk calculator has both 10 year and lifetime risk calculations available and has been updated annually. It has the advantage of a more diverse patient population than the old Framingham calculator and includes socioeconomic status including zip codes for those living in the UK to help derive the risk calculation. So how does the QRISK2-2014 app stand up to the venerable ASCVD Risk Estimator app?
Evidence based medicine
The evidence behind the QRISK2-2014 app is robust. The medical app has been utilizied in the UK since 2009 and has been validated in cohorts of over 2 million people including a more diverse racial population than Framingham. It has been shown in several research studies to outperform other risk calculators including Framingham. However, the website for QRISK now has the option to use 2015 data.
Who would benefit from this App?
Students, nurses, residents, mid-levels, primary care or any specialty medical provider who needs a good CV risk calculator app.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Simple to use interface with easier data input (to a degree) compared to the ASCVD app.
- Uses a more up to date and larger data set for risk calculations than Framingham or pooled equations apps.
- One of the only medical apps to include socioeconomic status in calculation (zip codes for those in the UK).
- Font along bottom of user interface difficult to read/use.
- No lifetime risk calculation included.
- Lacks additional lipid guideline information found in the ASCVD Risk Estimator app.
- Not available for Android at this time.
Every provider in primary care and hospital medicine needs a good reliable CV risk calculator and QRISK2-2014 fits the bill nicely. The medical app is a good alternative to the ASCVD Risk Estimator especially for those in the UK due to the ability to include “zip codes”. However, the QRISK2 app lacks some of the helpful information about the use of statins and lacks the lifetime risk calculation found in the ASCVD app.
- Overall Score
- User Interface
Easy to use interface with quick data input via multiple options. The font along the bottom though is smaller than it should be for ideal usability.
- Multimedia Usage
App has links to the QRISK2 website where you can find abundant additional information about QRISK and the studies behind it. The app would be improved if that information were to be built in similar to the ASCVD Risk Estimator app.
App is $0.99 which is reasonable, but the website is free: http://www.qrisk.org/
- Real World Applicability
QRISK2-2014 is the most current cardiovascular risk calculator available and in app form is a pleasure to use. This app is a great alternative to the AHA/ACC pooled equations risk calculator though with fewer bells and whistles. This is an app that every primary care provider could use daily. It would be even better if it included the lifetime risk calculations available at: http://www.qrisk.org/lifetime/
- Device Used For Review
iPhone 6S running iOS 9.3.1
- Available for DownloadiPhoneiPad