Reference
Publications
- Tunstall-Pedoe H, Woodward M, Tavendale R, A'Brook R, McCluskey MK. Comparison of the prediction by 27 different factors of coronary heart disease and death in men and women of the Scottish Heart Health Study: cohort study. BMJ 1997; 315: 722-729. Describes the Scottish Heart Health Extended cohort and the risk factors measured, showing their apparent importance one by one. Won a national epidemiology award for its authors.
- Tunstall-Pedoe H, Woodward M; SIGN group on risk estimation. By neglecting deprivation, cardiovascular risk scoring will exacerbate social gradients in disease. Heart 2006; 92 (3): 307-10. Epub 2005 Sep15. Argument for importance of social deprivation as a risk factor missing from Framingham score. Based on follow-up of SHHEC and application of the SIMD score to its participants. Led to the proposal to develop a new score - ASSIGN
- Woodward M, Brindle P, Tunstall-Pedoe H. Adding social deprivation and family history to cardiovascular risk assessment: the ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Heart 2007: 93(2):172-6. Development of ASSIGN score and testing 'validation' against the Framingham score.
- Risk Estimation and the Prevention of Cardiovascular Disease. SIGN guideline 97. The context within which the ASSIGN score was developed and within which it is being implemented in clinical practice in Scotland.
- Anderson KM, Odell PM, Wilson PW, Kannel WB. Cardiovascular disease risk profiles. Am Heart J 1991; 121:293-8. The Framingham cardiovascular score with which ASSIGN was compared. Apparently not available on the web.
- Hippisley-Cox J, Coupland C, Vinagradova Y, Robson J, May M, Brindle P. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: a prospective open cohort study. BMJ 2007; 335:136 Development of a score in England which copied the innovative features of ASSIGN and added extras. This analysis validated the ASSIGN score in a different population by showing that it discriminated futures cases from non-cases slightly better than the Framingham score, and did almost as well as QRISK in QRISK’s own host population. QRISK was not free from problems – its coefficients have been changing with a series of publication since this one. It uses a different index of deprivation to ASSIGN. An independent comparison in an English population reported ASSIGN preferable to Framingham and QRISK in evidence submitted to a NICE committee in 2008, and reported in the media in 2009, but not so far in the peer-reviewed literature. QRISK is calibrated to identify fewer people than Framingham or ASSIGN as high-risk, particularly below age 55.
Related Links and Web References
- Adding social deprivation and family history to cardiovascular risk assessment
- Appendix to Heart paper
- SIGN Guideline 97
- Midspan health surveys
- Heart Paper: 'By neglecting deprivation, cardiovascular risk scoring will exacerbate social gradients in disease'
- 2003 Scottish Health Survey
- Scottish Intercollegiate Guidelines Network (SIGN)
- Scottish Index of Multiple Deprivation (SIMD)
- BMJ Paper: 'Derivation and validation of QRISK'
- Comparison of the prediction by 27 different factors of coronary heart disease