The Sandwell Project: A controlled evaluation of a programme of targeted screening for prevention of cardiovascular disease in primary care

Abstract

Background: A pilot cardiovascular disease prevention project was implemented in the inner-city West Midlands. It was evaluated by comparing its effectiveness to a control group where full implementation was delayed by a year.

The effect of blood pressure and cholesterol variability on the precision of Framingham cardiovascular risk estimation: a simulation study

“…23 The likelihood of frequent misclassification of those in low-risk populations, in common with both the economics and practical evidence, argues against the universal cardiovascular risk factor assessment and for targeting those who are most likely to be at high risk. 23,24 Age and sex are strong predictors of cardiovascular risk and subject to little measurement error. Preselecting patients who are most likely to be at high risk on the basis of age and sex would greatly reduce misclassification.…”

Screening for increased cardiometabolic risk in primary care: a systematic review

“…9,11,13 The latter studies all concerned apparently healthy populations. Particularly in these populations a stepwise method can be useful, as a substantial part of them will be healthy.…”

“…Five studies focused on apparently healthy patients only (Table 1), [9][10][11][12][13] including the four most recently published. The number of people eligible for screening ranged from 361 to 24 166.…”

“…Three of the five studies performed in an apparently healthy population used a stepwise approach. 9,11,13 Calculation of a risk score based on a questionnaire completed by patients, 9 data available in electronic medical records, 11 or self-measuring waist circumference, 13 were used as first screening steps; subsequently people with scores above a threshold were invited for additional examinations.…”

“…Four studies in apparently healthy populations actively invited people to participate in the screening, by a written invitation from their GP, 9,11,13 or by either their own GP or an alternative provider. 10 One study used an opportunistic approach: eligible males were asked during a regular GP visit to participate in screening.…”