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一个用于指导心血管危险因素管理和开处方的简单计算机程序。

A simple computer program for guiding management of cardiovascular risk factors and prescribing.

作者信息

Hingorani A D, Vallance P

机构信息

Centre for Clinical Pharmacology, Wolfson Institute for Biomedical Research, University College London, London W1P 9LN.

出版信息

BMJ. 1999 Jan 9;318(7176):101-5. doi: 10.1136/bmj.318.7176.101.

Abstract

OBJECTIVE

To describe, and to test against trial data, a simple and flexible computer program for calculating cardiovascular risk in individual patients as an aid to managing risk factors and prescribing drugs to lower cholesterol concentration and blood pressure.

DESIGN

Descriptive comparison of actual cardiovascular risk in randomised controlled trials of cholesterol reduction with risk predicted by a computer program based on the Framingham risk equation. Comparison of the program's performance with that of tables and guidelines by means of hypothetical case examples.

MAIN OUTCOME MEASURES

Average risk of coronary heart disease and myocardial infarction.

RESULTS

The computer program accurately predicted baseline absolute risk in a UK population as well as the relative and absolute reduction in risk from cholesterol lowering for primary prevention of coronary heart disease. The program also allowed a more refined estimate of absolute risk of coronary heart disease than some existing tables and enabled the impact of prescribing decisions to be quantified and costed.

CONCLUSIONS

This simple computer program to estimate individuals' cardiovascular disease risk and display the benefits of intervention should help clinicians and patients decide on the most effective packages of risk reduction and identify those most likely to benefit from modulation of risk factors.

摘要

目的

描述并根据试验数据测试一个简单灵活的计算机程序,该程序用于计算个体患者的心血管风险,以辅助管理风险因素并开具降低胆固醇浓度和血压的药物处方。

设计

在胆固醇降低的随机对照试验中,将实际心血管风险与基于弗雷明汉风险方程的计算机程序预测的风险进行描述性比较。通过假设病例示例,将该程序的性能与表格和指南的性能进行比较。

主要观察指标

冠心病和心肌梗死的平均风险。

结果

该计算机程序准确预测了英国人群的基线绝对风险以及降低胆固醇用于冠心病一级预防时风险的相对和绝对降低情况。与一些现有表格相比,该程序还能对冠心病的绝对风险进行更精确的估计,并能对处方决策的影响进行量化和成本核算。

结论

这个用于估计个体心血管疾病风险并展示干预益处的简单计算机程序,应有助于临床医生和患者决定最有效的降低风险方案,并识别出最有可能从风险因素调节中获益的人群。

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