It could hardly be simpler: go to the Web, pull up a point-system tool, plug in a few numbers and instantly calculate your chances of having a heart attack over the next 10 years. A new study finds that a widely used version of the ubiquitous heart attack risk calculator is flawed, misclassifying 15 percent of patients who would use it — almost six million Americans, of whom almost four million are inappropriately shifted into higher-risk groups that are more likely to be treated with medication. And while the tool is easy to use, the authors say, the original calculator on which it is based is equally user-friendly for anyone with a computer — and significantly more reliable. The number of Americans potentially affected is in the millions. Ten percent of adults are shifted into higher-risk groups by the simplified system; at the same time, the system underestimates the risk for 5 percent of adults, who might benefit from more aggressive therapy. Women are disproportionately represented among the low-risk patients who are shifted into a higher-risk category. “Even if it’s just a 5 percent difference of undertreatment versus overtreatment — why use a less accurate method?” said Dr. Kevin Fiscella, a professor of family and preventive medicine at the University of Rochester. “Especially when it’s quite easy to use a more accurate method with electronic devices.” Dr. Fiscella is a co-author of an editorial in the same journal about the study. By RONI CARYN RABIN
Published: September 20, 2010
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