QRisk2® Available as Open Source Software

The University of Nottingham and leading healthcare systems supplier EMIS have made the QRisk2® formula for identifying heart disease risk available as open source software.

The move follows a new independent evaluation of QRisk2 by researchers at the University of Oxford, which found it was more accurate than the Framingham risk assessment tool at predicting cardiovascular risk in the UK population.

Dr Gary Collins, senior medical statistician at the University of Oxford, concluded: "We have assessed the performance of QRisk2 against the NICE version of the Framingham equation and have provided evidence to support the use of QRisk2 in favour of the NICE Framingham equation."

Professor Julia Hippisley-Cox of the University of Nottingham's Division of Primary Care and medical director of ClinRisk Ltd, the company behind the QRisk2 software, said: "We are very pleased that code implementing the QRisk2 algorithm is now available, under the open source model, free of charge to all.

"QRisk2 is more accurate for our ethnically diverse UK population, and has the potential to save many thousands of lives from heart disease - the nation's biggest killer. It will arm users with all the information they need to decide how best to target patients at risk."

Dr David Stables, EMIS Director of Strategic Development and co-founder of QResearch® - the clinical database that was used to develop QRisk2 - commented: "EMIS is delighted that QRisk2 is now available as open source software. "In addition to being implemented within EMIS systems - covering 52 per cent of all UK GP practices - QRisk2 has now been adopted by almost all the other GP system suppliers, many PCTs and pharmacies and a number of hospitals. This latest move will open it up to even more users - which can only be of huge benefit to the nation's health."

In March, the National Institute for Clinical Excellence (NICE) updated its guidance to give clinicians free choice of the most appropriate cardiovascular disease risk assessment tool - including QRisk2. NICE withdrew its recommendation to clinicians to use the Framingham risk assessment tool, but stopped short of recommending QRisk2 in its place.

  • The QRisk research was undertaken using the QResearch anonymised primary care database at the University of Nottingham in collaboration with the University of Edinburgh, Bristol PCT and St Mary's School of Medicine and Dentistry, London.
  • More than 500 EMIS LV practices, representing around nine million patients, regularly contribute to the database, and over two million of these patients are included in the QRisk dataset. www.qresearch.org
  • The QRisk2 software was developed in collaboration with ClinRisk Ltd, a medical software company that produces algorithms for clinical use together with open and closed source software to help their reliable implementation into clinical practice. ClinRisk Ltd continues to licence and support its fully-featured software development kits. More information is available at http://www.qrisk.org and http://www.emis-online.com/QRisk2
  • Unlike the Framingham equation, QRisk2 is based on UK populations and takes into account the higher risk of developing CVD to patients from deprived areas and from certain ethnic groups, particularly those with a South Asian background. It also considers other risk factors, including whether the patient already suffers from a pre-existing condition such as diabetes. It is more accurate for a contemporaneous ethnically diverse UK population.
  • A summary of the University of Oxford research is available at http://www.bmj.com/cgi/content/full/340/may13_2/c2442

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