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Objective To evaluate the performance of the QStatin scores for predicting the 5-year risk of developing acute renal failure, cataract, liver dysfunction and myopathy in men and women in England and Wales receiving statins. Design Prospective cohort study to evaluate the performance of four statin risk prediction models. Setting 364 practices in the UK contributing to The Health Improvement Network database. Participants 2.2 million patients aged 35e84 years registered with a general practice surgery between 1 January 2002 and 30 June 2008, with 2037 incident cases of acute renal failure, 25 692 incident cataract cases, 14 756 cases of liver dysfunction and 1209 incident cases of myopathy. Main outcome measures First recorded occurrence of acute renal failure, cataract, moderate or severe liver dysfunction and moderate or severe myopathic events as recorded in general practice records. Results Results from this independent and external validation of QStatin scores indicate that models predicting the 5-year statin risk of developing acute renal failure, cataracts and myopathy perform well with areas under the receiver operating characteristic curve ranging from 0.73 to 0.87. Calibration plots for the three models also indicated close agreement between observed and predicted risks. Poor performance was observed for the model predicting the 5-year statin risk of developing liver dysfunction with areas under the receiver operating characteristic curve of 0.64 and 0.60 for women and men, respectively. Conclusions QStatin scores for predicting the 5-year statin risk of developing acute renal failure, cataract and myopathy appear to be useful models with good discriminative and calibration properties. The model for predicting the 5-year statin risk of developing liver dysfunction appears to have limited ability to identify high-risk individuals and the authors caution against its use. [ABSTRACT FROM AUTHOR]

The article focuses on a study which evaluated the performance of the QRISK score for predicting 10 year risk of cardiovascular disease in an independent cohort of patients in England and Wales from general practice and compared the performance with Framingham equations. The study found that QRISK provides an improved performance in predicting the 10 year risk of cardiovascular disease. A better QRISK was also noted in discrimination and calibration statistics. It was also observed that the incidence of cardiovascular disease in men was higher compared to women.

Objective: To independently evaluate the performance of the QRISK score for predicting 10 year risk of cardiovascular disease in an independent UK cohort of patients from general practice and compare the performance with Framingham equations., Design: Prospective open cohort study., Setting: 274 practices from England and Wales contributing to the THIN database., Participants: 1.07 million patients, registered between 1 January 1995 and 1 April 2006, aged 35-74 years (5.4 million person years) with 43 990 cardiovascular events., Main Outcome Measures: First diagnosis of cardiovascular disease (myocardial infarction, coronary heart disease, stroke, and transient ischaemic attack) recorded in general practice records., Results: This independent validation indicated that QRISK offers an improved performance in predicting the 10 year risk of cardiovascular disease in a large cohort of UK patients over the Anderson Framingham equation. Discrimination and calibration statistics were better with QRISK. QRISK explained 32% of the variation in men and 37% in women, compared with 27% and 31% respectively for Anderson Framingham. QRISK underpredicted risk by 13% for men and 10% for women, whereas Anderson Framingham overpredicted risk by 32% for men and 10% for women. In total, 85 010 (8%) of patients would be reclassified from high risk (>or=20%) with Anderson Framingham to low risk with QRISK, with an observed 10 year cardiovascular disease risk of 17.5% (95% confidence interval 16.9% to 18.1%) for men and 16.8% (15.7% to 18.0%) for women. The incidence rate of cardiovascular disease events among men was 30.5 per 1000 person years (95% confidence interval 29.9 to 31.2) in high risk patients identified with QRISK and 23.7 per 1000 person years (23.2 to 24.1) in high risk patients identified with Anderson Framingham. Similarly, the incidence rate of cardiovascular disease events among women was 26.7 per 1000 person years (25.8 to 27.7) in high risk patients identified with QRISK compared with 22.2 per 1000 person years (21.4 to 23.0) in high risk patients identified with Anderson Framingham., Conclusions: The QRISK cardiovascular disease risk equation offers an improvement over the long established Anderson Framingham equation in terms of identifying a high risk population for cardiovascular disease in the United Kingdom. QRISK underestimates 10 year cardiovascular disease risk, but the magnitude of underprediction is smaller than the overprediction with Anderson Framingham.