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Risk assessment gone mad: the rise of risk evaluation and mass public deception

Despite listing several important caveats, the Framingham risk score was widely adopted around the world, largely because of its novelty, simplicity and practicality. Some four decades later, there is mounting criticism of the Framingham risk score. First, because it does not predict cardiovascular risk ‘accurately’ enough – when applied to different populations, the score tends to overestimate risk in low-risk populations and underestimate risk in high-risk populations. Second, because it does not take into account other factors such as family history or socio-economic status. New risk scoring systems have been proposed, each claiming to predict, with greater accuracy than Framingham, the risk…

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 Framingham Risk Score might be outdated to assess CV disease risk

The Framingham Risk Score system for assessing the risk of cardiovascular disease among older people should be replaced with something more accurate, according to a study published Jan. 8 in the British Medical Journal (BMJ).

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Rethinking the Framingham Score: Is There a Better Way to Predict Heart Disease?

Doctors are constantly telling us that prevention is the best medicine, especially when it comes to chronic problems like heart disease. The key to a good prevention strategy is, of course, controlling the risk factors that contribute to disease. But now a new study shows that a commonly used measure to predict — and therefore help prevent — heart disease may not be as accurate as previously thought.

Beyond Framingham: Risk Assessment and Treatment Approaches for Cardiovascular Disease Patients in Ethnically Diverse Populations

There are some limitations, however, concerning the Framingham risk score. As you know, the Framingham study involved 5200 patients from Framingham, Massachusetts, about two-thirds of the population and one of the criticisms of the Framingham score is that is it really applicable to other populations? Over time there have been a lot of studies that have validated that with correction and conversion factors, you can satisfy and predict risk in some of these patients, even though they may not be of the same profile as you would see from the Framingham study. So I think it's important that we realize that one of the limitations is that it was a very small population; however, over time the Framingham score has been found to be applicable to a broader scope of patients. Some of the other criticisms is that it doesn't include triglycerides and doesn't include concepts with diet and exercise -- risk factors that we know to be important -- and those are some of the shortcomings. But, over time, it has proven to be a rather effective way of scoring for risk.

Calling for a New Framingham: Machine Learning in Cardiovascular Risk Assessment—The Key for Improved Outcome Prediction?∗

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Framingham score adapted: a valid alternative for estimating cardiovascular risk in epidemiological studies

Framingham risk score (FRS) is an important cardiovascular risk assessment tool, based on objective measurements of blood pressure and lipid profile, among other factors. However, in large population surveys, these measures are not always available, which limits their use.

Framingham Score May Not Spot Lifetime Heart Risk

The new study specifically found that the Framingham Risk Score may be good at predicting the 10-year probability of heart attack or stroke for people younger than 50, but it falls short at assessing longer-term risk.

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The “2012 Update of the Canadian Cardiovascular Society Guidelines for the Diagnosis and Treatment of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult” introduces a modified Framingham Risk Score, which is the 10-year Framingham risk percent doubled for family history of premature cardiovascular disease (CVD).1 However, clinicians should avoid using this modification for a number of reasons. First, there is no compelling rationale to include family history, or any other risk factor (or their combination), because the Framingham Risk Score produces a perfectly reasonable risk stratification.

Systematic Examination of the Updated Framingham Heart Study General Cardiovascular Risk Profile

An updated Framingham risk prediction tool was recently published. It features an expanded end point of general cardiovascular disease and a “vascular age” risk communication analogy.

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