Tools

Risk Calculators/Tools for cardiology, dermatology, endocrinology, gastroenterology, hematology, infectious disease, neurology, obstetrics/gynecology, ophthalmology, psychiatry, respiratory, rheumatology, oncology - the list is fairly limited so far - please let us know if you would like tools added

1) Cardiology

CVD risk calculators

Cardiovascular Risk/Benefit/Harm Calculator

Uses both Framingham and the new ASCVD formulas. Gives benefit estimates for all treatments - drug and non-drug. The BEST tool for calculating cardiovascular risk. (We are biased in our review of this tool!)

Dr Mark McConnell from the VA says this is "the best risk calculator I’ve found

New Zealand Cardiovascular Risk Charts

NIce charts which turn the Framingham risk scores into visual aides, enabling patients to see their risk compared to others.

Edinburgh cardiovascular risk calculator

Has different chart styles including smiley faces and thermometers and in some formats gives estimate of benefit - based on the design of the Joint British Societies (JBS) Cardiovascular Disease Risk Prediction Charts.

Primary CVD risk calculator

This risk calculator uses the Framingham risk equation and the adjustments as suggested by the Joint British Societies' (JBS2) paper and the JBS Cardiovascular Risk Assessor.

Reynolds Risk Score

Calculates CVD risk and incorporates hsCRP.

Australian absolute CVD risk calculator 

Another Framingham based calculator.

2013 Prevention Guideline CV risk calculator

This calculator is a companion tool to the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk.

JBS3 CVD risk assessor

CV risk assessor program is for use with the Joint Recommendations of the British Cardiac Society, British Hypertension Society, Diabetes UK, HEART UK, Primary Care Cardiovascular Society and Stroke Association: Prevention of Cardiovascular Disease in Clinical Practice.

JBS CVD risk prediction charts

British Hypertension Society calculator.

UKPDS risk engine

Calculates CVD risk for patients with diabetes and different A1cs can be added which is different than most other calculators which chart diabetes as Yes or No.

Australian CVD risk charts

Charts are based on the NVDPA’s Guidelines for the assessment of absolute cardiovascular disease risk.

New Zealand Know your numbers

Framingham Heart Study CVD RISK

A project of the NHLBI and Boston University.

QRISK

The QRISK2 algorithm has been developed by doctors and academics working in the UK National Health Service and is based on routinely collected data from many thousands of GPs across the country who have freely contributed data for medical research.

CVD risk check

The risk assessment tool above uses information from the Framingham Heart Study as recommended by the 2009 CCS Canadian Cholesterol Guidelines.

PROGETTO CUORE Individual Risk Score

CHART - Estimate 5-year CVD risk without measuring cholesterol or CRP

CHD risk calculators

PROCAM Health Check

Based on the latest and most comprehensive analysis of PROCAM.

Framingham Hard Coronary Heart Disease

A project of the NHLBI and Boston University.

CVD mortality calculator

SCORE

Risk calculator for the European Society of Cardiology, European Society of Hypertension and the European Atherosclerosis Society.

Statin and Aspirin

Mayo Statin and Aspirin Decision Aid

A happy face based tool to help patients make decisions about statins and/or ASA.

2) Dermatology

None yet

3) Endocrinology

UKPDS risk engine

Calculates CVD risk for patients with diabetes and different A1cs can be added which is different than most other calculators which chart diabetes as Yes or No.

CHART - 55 year-old diabetes risk table

 

4) Gastroenterology

GI bleeds

HAS-BLEED

Estimates one-year risk of major bleeding in atrial fibrillation patients.

5) Hematology

None yet

6) Infectious disease

Pneumonia severity index calculator

A prediction rule to identify low-risk patients with community acquired pneumonia.

Best Antibiotic Sensitivity Chart Ever - PDF

7) Neurology

Stroke risk/benefit/harm 

Sparc tool

A great tool for going over the risks and benefits of preventive treatments for stroke.

Stroke risk

CHADS-2

Estimates stroke risk in patients with atrial fibrillation.

8) Obstetrics/gynecology

None yet

9) Ophthalmology

None yet

10) Psychiatry

None yet

11) Respiratory

Lung Age

Show someone who smokes how “old” their lungs are in a nice visual. A trial showed that using this helped patients quit smoking.

12) Rheumatology/Bone health 

Fracture risk

WHO-FRAX

Likelihood of fracture for many populations around the world. Can even calculate risk without a BMD reading.

A simple to use chart based on FRAX - Estimate risk of fracture NOT KNOWING BMD

Click here for a large version

 A simple to use chart based on FRAX- Estimate risk of fracture KNOWING BMD 

Click here for a large version

WHI

Another fracture risk calculator, best for US populations. You don’t need a BMD to calculate risk.

CHART - Estimate osteoporosis risk

13) Oncology

None yet

13) Others

Make your own decision aides!

Take any study and make a nice diagram to use with patients.

Comments

I have just run across a book "The illusion of certainty : Health benefits and risks" http://preview.tinyurl.com/n6fb5a and was interested in your thoughts. Have you read it? If so is it a worthwhile read? Is there any evidence surrounding the use of visual tools to contextualize the risk/benefit data for patients? Do you have a favourite tool that you use to help patients understand what the numbers mean?

Thanks

Penny

Hi Penny - sorry for the delay in my response - it took me a while to have a quick look at the content of this book - while I only skimmed the information I was very impressed with how the authors were presenting the risk/benefit information - they seemed to be doing all of the things Mike and I typically suggest should be done - the quote from the book at the bottom of this comment really encapsulates what patients need to be able to do - at least those interested in participating in the decision-making process.

I tend not to use visual tools as I find most people understand (although I may have a biased view point as I typically talk with a select population who is already interested in this area) if I tell then what their approximate risk is (in %) without treatment and their approximate risk (in %) with treatment over a period of time. Then obviously, the benefit is the difference between the 2 numbers. Hope this helps. Thanks for posting a comment.

A quote from the book “The illusion of certainty : Health benefits and risks”

"If you don’t have the ability to discuss the results of studies on which your doctor is basing her recommendations, it is very hard to be an informed partner. This does not mean you have to understand all the science involved. It does mean that when an article provides numbers for the risk or benefit of something, you need to be able to understand what the numbers are saying. That understanding will allow you to be a true partner with your doctor. It will enable you to discuss how you feel about the proposed intervention. It is not that you want to debate an article with your doctor. It’s that you want to have a common language to discuss how your medical options align with your personal values and wishes. You need to be on the same page as your doctor if you are going to discuss what treatments are compatible with your own sense of the risk you are willing to take. These lessons will improve your communication with your doctor, and they will let you form a closer partnership with him."

these tables are awesome.