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Development and validation of a prediction rule for recurrent vascular events based on a cohort study of patients with arterial disease: the SMART risk score
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  • Published on:
    Re:Re:Use SMART risk score to correct under- and overtreatment.

    As was pointed out by dr. Thomas and dr. Pleumeekers in personal communication, we have to admit that the case of a 70-year old patient with a 15% 10-year risk is not unthinkable. For example, a patient with the following characteristics has a predicted 15% 10-year risk for recurrent cardiovascular events: male 70 years, no smoker, systolic blood pressure 130 mmHg, diabetes mellitus no, CAD yes, CVD no, AAA no, PAD no,...

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    Conflict of Interest:
    None declared.
  • Published on:
    Re:Use SMART risk score to correct under- and overtreatment.

    Complex drug regimens and overtreatment in elderly persons are important medical issues. Less stringent treatment for example of blood pressure, may be allowed or is even advisable in the elderly, especially in the presence of coexisting morbidities, adverse side effects of medication or impaired mobility. Still, the SMART risk score will not help determine which patients can safely withdraw treatment for several reasons...

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    Conflict of Interest:
    None declared.
  • Published on:
    Use SMART risk score to correct under- and overtreatment.
    • Siep Thomas, Prof. Em of General Practice
    • Other Contributors:
      • Ber Pleumeekers

    Dorresteijn et al, (Heart 2013;99:866-872), presented a new tool, the SMART risk score, for predicting 10 year risk of recurrence in patients with established cardiovascular disease. This enables clinicians for the first time to differentiate treatment within the hitherto broadly assumed recurrence rate of at least 20% leading to guidelines that, so far, advise maximal drug treatment for elevated risk factors for all patie...

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    Conflict of Interest:
    None declared.