Disclaimer and limitations

• The authors and sponsors of the ASSIGN (v2.0) score disclaim responsibility for misuse or abuse in clinical practice. It should be used as a guide to preventive treatment in identifying individuals estimated to be at high risk of developing CVD. All data entered should be checked for plausibility and accuracy.

 

• There is no guarantee that any individual for whom the ASSIGN (v2.0) score is calculated will, or will not, develop cardiovascular disease within ten years. The score is a risk estimator not a precise predictor. The score should be used within the context of relevant guidelines on the management of cardiovascular risk and is not a replacement for clinical judgement and individualised treatment.

 

• Whilst the calculator accepts inputs of systolic blood pressure up to 250mmHg, it is important that, in cases of confirmed elevated blood pressure readings, clinicians follow guidelines for treatment and onward referral as appropriate. For example: Adult hypertension referral pathway and therapeutic management: British and Irish Hypertension Society position statement

 

• Cohorts - The SHHEC cohort used in the initial ASSIGN development included individuals aged 30-74 at time of recruitment. For the recalibration process the study population used were aged 40-69. Estimating risk beyond these values therefore involves a degree of extrapolation and the resulting score should be interpreted with caution. Neither UK Biobank nor Generation Scotland Scottish Family Health study used in the recalibration process are entirely nationally representative. However, we are aware of no such other contemporary Scottish cohort of the required size.

 

• Limitations of the calculator - This calculator does not specifically include the effects of some other recognised individual risk characteristics, or medical conditions including atrial fibrillation (AF), ethnicity or severe mental illness and therefore may not reliably estimate risk for certain individuals. Do not rule out the option of statin treatment if the person's ASSIGN score is <10 and there are individual factors which suggest the risk is underestimated or the person has an informed wish for statin treatment.

 

• For people from minority ethnic groups, cardiovascular risk tools may under or overestimate risk if they have not been validated in those populations. See SIGN 149 section 4.3 for further detail. It should be noted that an update of SIGN 149 is planned for 2025.

 

• If the person has AF, then an appropriate and validated risk assessment should be performed to inform optimal risk reduction relating to the presence of AF and any associated individual factors.

 

• In patients aged < 40 years with diabetes, 10 year risk scoring may underestimate the person's lifetime risk of CVD and risk factor management should therefore be individualised.

 

• The definition of family history for the purposes of the ASSIGN calculator is parents and siblings with CHD or stroke below the age of 60 years. It should be noted that the family history questionnaire answered by the cohorts used in the recalibration process did not specify the age of first-degree relatives affected by cardiovascular disease (defined as heart disease and stroke).

 

• The calculator name ASSIGN (v2.0) reflects that this is a second, recalibrated version of the original ASSIGN calculator, which was launched in 2006. However, the regulatory information refers to the current ASSIGN calculator as v1.0. This is because this recalibrated version is the first version of the ASSIGN calculator to be registered with the MHRA as a class 1 medical device.