Advancing cardiovascular risk assessment: Real-time SCORES2 calculation through CDSS in primary care patients

Individualized cardiovascular risk stratification is recommended to guide treatment. The objective was to report the 10-year cardiovascular disease (CVD) risk in primary care patients without previous CVD or diabetes using the SCORE2 risk prediction algorithms, SCORE2 (age 40-69 years), and SCORE2-OP (age 70-89 years) scales, as per the European Society of Cardiology guidelines. The risk levels were categorized as low-moderate (<5 %), high (5-10 %), or very high (>10 %), with recommendations for treatment, through the clinical decision support system (CDSS).

A cross-sectional study was designed in collaboration with general practitioners. The CDSS, integrated with computerized patient order entry, facilitated the calculation for CVD-free individuals after electronic medical record consultation. We counted the patients offered SCORES calculation, the number of acceptances and calculations, the results obtained, risk factors, along with adherence to recommended treatment.

SCORES were offered to 971 patients, 635 SCORE2 and 336 SCORE2-OP, and 614 (96.7 %) SCORE2 and 160 (47.6 %). SCORE2-OP calculations were accepted, showing a significantly different acceptance rate. There was a significantly higher prevalence of smoking habit (P < 0.01) and hypertension (P < 0.01) among SCORE2 patients. Half of the SCORE2 patients were classified as low risk, more than 80 % of SCORE2-OP as high or very high risk. The adherence to treatment recommendations was 90.4 % overall, with a significant difference between SCORE2 (93.9 %) and SCORE2-OP (74.0 %) (P < 0.01).

The laboratory, in collaboration with clinicians and utilizing CDSS, plays a central role in clinical decision-making by reporting SCORE2 risk prediction algorithms and treatment recommendations.