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Reduced screening could maximise benefits of CVD check-ups

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In the UK, there are 55,000 deaths each year attributed to 'non-communicable' diseases such as CVD. That boils down to 166 deaths per 100,000 people. While this is better than the EU average of 200 deaths per 100,000, the charity HEART UK estimates that cardiovascular disease (CVD) costs the UK economy around £19 billion each year. Almost half of this is in direct healthcare costs.

The current strategy is for mass screening of patients to identify at-risk patients before they become ill. These screenings are usually offered to otherwise healthy adults over the age of 40. However, a study carried out at the University of Birmingham has concluded that this approach may be wasteful of resources and unnecessarily expensive. Instead, its authors suggest it would be better to target those most at risk of CVD. This would reduce CVD screening costs and the time it takes to conduct check-ups.

A global issue – has the solution been found in Birmingham?

CVD was at the top of the agenda at the two-day conference of the World Innovation Summit for Health, held in Doha in December 2016. It's estimated that it costs around £30 trillion a year in lost economic output. CVD is the number one killer in the world.

Lord Darzi, a surgeon and former UK government health minister, believes that CVD prevention is lacking. He says, "If behavioural and lifestyle factors increasingly drive the majority of years of healthy life lost, then isn't it time we attack these issues at their causal roots, not just the symptoms?"

He may be right, but understanding the behavioural issues that increase the risk of CVD is at the heart of the study conducted at the Institute of Applied Health Research at the University of Birmingham.

Introducing the CVD risk score

Researchers simulated the outcomes of 10,000 patients aged between 30 and 74 years old. They used their CVD risk factors outlined in their electronic medical records. The risk factors included:

  • Age
  • Gender
  • Smoking habits
  • Diet
  • Alcohol consumption

The study showed that the most cost-effective screening strategy was to rank patients by their CVD risk score and screen the 8% most at risk. There are diminishing returns by inviting everyone over the age of 40 for screening.

Patients can calculate their own risk of CVD

The study used risk scores calculated by a computer. Anyone can calculate their own CVD risk by using the online application, QRISK calculator.

The researchers also noted that other mass screening programmes might also be similarly better targeted.

Could this type of research lead to a different methodology in the GP practice? Take a few simple readings, plug the results into a computer, and screen for the most likely diseases and ailments on a patient-by-patient basis?

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