Open AccessClinical Utility of a Novel Coronary Heart Disease Risk‐Assessment Test to Further Classify Intermediate‐Risk Patients
Author(s) -
Solomon Matthew D.,
Tirupsur Ahalya,
Hytopoulos Evangelos,
Beggs Michael,
Harrington Douglas S.,
French Cynthia,
Quertermous Thomas
Publication year - 2013
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.22185
Subject(s) - medicine , test (biology) , risk assessment , framingham risk score , risk stratification , disease , physical therapy , family medicine , intensive care medicine , paleontology , computer security , computer science , biology
Abstract Background Current coronary heart disease ( CHD ) risk assessments inadequately assess intermediate‐risk patients, leaving many undertreated and vulnerable to heart attacks. A novel CHD risk‐assessment ( CHDRA ) tool was developed for intermediate‐risk stratification using biomarkers and established risk factors to significantly improve CHD risk discrimination. Hypothesis Physicians will change their treatment plan in response to more information about a patient's CHD risk level provided by the CHDRA test. Methods A Web‐based survey of cardiology, internal medicine, family practice, and obstetrics/gynecology physicians (n = 206) was conducted to assess the CHDRA clinical impact. Each physician was shown 3 clinical vignettes representing community‐based cohort participants randomly selected from 8 total vignettes. For each, the physicians assessed the individual's CHD risk and selected preferred therapies based on the individual's comorbidities, physical examination, and laboratory results. The individual's CHDRA score was then provided and the physicians were queried for changes to their initial treatment plans. Results After obtaining the CHDRA result, 70% of the physician responses indicated a change to the patient's treatment plan. The revised lipid‐management plans agreed more often (74.6% of the time) with the current Adult Treatment Panel III guidelines than did the original plans (57.6% of the time). Most physicians (71.3%) agreed with the statement that the CHDRA result provided information that would impact their current treatment decisions. Conclusions The CHDRA test provided additional information to which physicians responded by more often applying appropriate therapy and actions aligned with guidelines, thus demonstrating the clinical utility of the test.