Does calculator overstate heart attack risk?

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(CNN) — Apparent problems with an online calculator, released last week along with new cholesterol guidelines, prompted one expert Monday to suggest implementation of the guidelines be postponed.

The risk calculator, meant to assist doctors in evaluating patients’ risk and treatment options for cholesterol, appears to greatly overstate risk, according to a report Sunday in The New York Times.

It could result in millions of people being incorrectly identified as candidates for cholesterol-lowering statin drugs, the report said.

The calculator, released by the American Heart Association and the American College of Cardiology, is a tool to evaluate a patient’s 10-year risk of a heart attack. According to the new guidelines, if a person’s risk is above 7.5%, he or she should be put on a statin.

However, in a hastily called telebriefing Monday morning, members of the committee who developed the calculator and guidelines said that they knew about the risk of overestimation before rolling out the assessment tool and that they welcome more information to help refine it.

The tool, they said, is only one part of evaluating patients’ treatment options — something that can only be done with the help of a doctor.

No one should be “mailed a prescription” based on the results of the assessment tool, said Dr. Neil Stone, committee chairman. “There’s got to be a physician-patient discussion. … We’ve put the physician back into crucial decision-making.”

However, “I can’t speak to whether the calculator is valid or not,” Dr. Robert Eckel, co-chair of the American Heart Association committee that wrote the new guidelines and the association’s past president, told CNN. “That needs to be determined.

“We trusted that the calculator worked,” he said. “We trusted that the calculator is valid.”

Read more http://www.cnn.com/2013/11/18/health/cholesterol-calculator/index.html?hpt=hp_t3

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