RAPID RESPONSES FROM BMJ.COM: Drawbacks of primary prevention risk tables to assess  cardiovascular risk in type 2 diabetes

doi:10.1136/bmjusa.03040003

BMJ, doi: 10.1136/bmjusa.03040003, (Published 6 May 2003)

Letter

RAPID RESPONSES FROM BMJ.COM

Drawbacks of primary prevention risk tables to assess cardiovascular risk in type 2 diabetes

Following is an edited excerpt from one of the Rapid Responsesgenerated by this article, which can be read in their entiretyat http://bmj.com/cgi/eletters/326/7383/251 — Editor

The first 150 words of the full text of this article appear below.

From BMJ USA 2003;April:202

Editor — The proposal implied by Hall et al would leadto a rather rigid prescribing protocol whereby all patientswith scores above a threshold (eg, 15%) would receive additionaltherapy, and others would not. In addition, the overemphasison risk scores might ignore other key risk factors not representedby the Framingham risk equation, such as ethnicity, familyhistory, microalbuminuria, and triglyceride concentration.The low baseline prevalence of diabetes in the Framingham cohortleads to wide confidence intervals in the predicted risk (±5-10%).Thus, in a diabetic man with average risk factors, the upper95% confidence interval crosses the 15% 10-year threshold from age 40 onwards. It is quite plausible that individuals withrisk scores below a chosen cutoff . . . [Full text of this article]