Framingham Risk Calculator
Supporting 2016 CCS Lipid Guidelines
And 2015 Simplified Lipid Guidelines
This calculator uses the
Input in the left column includes the risk factors of the Framingham Risk Score (FRS). Calculation of risk will proceed in real time as you enter the data, and you can change values as you wish to demonstrate reduction of risk if any of these factors are modified. For example, if the patient contemplates quitting smoking, you can demonstrate change in risk by absolute risk reduction, number needed to treat or by graph. Cardiovascular age is calculated as well. Several warning screens will appear in certain circumstances:
o Blood pressure must be entered prior to entry of BP treatment status
o Diabetes within a certain age group will receive a statin treatment reminder
o ASA treatment benefit is not shown past age 80. Any ASA recommendation will not appear until all risk factor data including family history is entered.
o All risk factors must be entered before diabetes if the patient is diabetic.
o All risk factors including diabetic status must be entered before family history if there is a history in a first degree relative before age 60
You do not need to start over if a warning screen has appeared.
It is important to reset the calculator using the Start Over button if a lot of changes have been made, or if you are entering values for a new patient. You can return to this screen using the Help button.
There are 5 quantifiable interventions available once data entry has been completed, although data completion is not necessary. Relative risk reduction is indicated on the entry button for each. Only one intervention can be evaluated at a time, but different interventions can be compared if you Return to Calculator and press an alternate button. The entered data will be preserved until you Start Over.
Choosing an intervention will yield the modified FRS, absolute risk reduction, number needed to treat and a graphic representation of the comparison between treated and untreated patients:
· Those having no events
Cardiovascular age will display during intervention calculation, but this figure may not be particularly accurate.
This occupies the right side of the
screen. Changes occur in real time as
data is entered or changed. On initial
data entry without intervention, the FRS and the percentage of patients
unaffected will appear. The graphic will
follow these numbers as percentage untreated having events or no events. Cardiovascular age will change as data is
entered and risk changes. As the FRS is
calculated, level of risk and recommendations regarding treatment threshold and
targets are displayed. Diabetes uses a
slightly different algorithm, but the text recommendation will appear if the
appropriate age range and
The ASA recommendation is simply a consideration for patients with a Framingham score over 20%. It will only be valid when data entry is complete and if ASA therapy could be considered. Effect is modest in primary care, and men are most likely to benefit. Bleeding risk must be part of the decision.
When an intervention is selected there will be percentage and graphical representation comparing those with no events, those with predicted 10 year events and events prevented. This is a 1 time calculation, and it will disappear when you return to the calculator, however the calculation can be repeated with a different intervention. You can use Print Screen if you need hard copy.
The calculator may be run from the website, however it will probably be faster to have the application run from your hard drive. The source files can be downloaded as Framingham Risk Calculator.zip from the calculators menu page or from here.
· Standard CCS calculator with graphic interface in SI units …………… CCSFramingham.html
· CCS calculator with dyslipidemia support in SI units ………………….... CardMetRisk.html
· The AHA/ACC calculator option has been removed, as the Simplified Lipid Guidelines are now represented in decision support along with the new CCS Guidelines. This now allows treatment based on risk rather than lipid levels.