App Review | ACC's ASCVD Risk Estimator Plus App
Purpose: The purpose of the ACC ASCVD Risk Estimator Plus App is to deliver the clinician or provider with an individualized, scientifically-derived estimate of the patient's 10-year risk of developing atherosclerotic cardiovascular disease (ASCVD) as well as their overall lifetime risk of ASCVD.
The app is meant to serve as a starting point for shared decision-making discussions and can help guide the development of a custom intervention plan. It also has functionality to project the potential benefit of specific risk-lowering interventions (i.e. statins, blood pressure medication, aspirin and smoking cessation) and the capability to update and track change in risk over time based on a patient's actual response to interventions. The 10-year ASCVD risk is calculated via the Pooled Cohort Equation published as part of the 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk.
The updated 10-year ASCVD risk at follow-up visits and projected 10-year ASCVD risk values are derived from the 2016 Million Hearts Longitudinal Risk Assessment Tool published as part of the Estimating Longitudinal Risks and Benefits from Cardiovascular Preventive Therapies Among Medicare Patients: The Million Hearts Longitudinal ASCVD Risk Assessment Tool. Content in the app will also be updated to reflect the upcoming revised 2018 ACC/AHA Guideline on the Management of Blood Cholesterol.
Size: 17.3 MB
Compatibility: This app requires iOS 9.0 or later and is compatible with iPhone, iPad and iPod touch. It is also available on GooglePlay and requires an Andriod 4.1 and up. There is an online web version that can be accessed at here.
Target Audience: The recommended audience includes all providers involved in managing a patient's risk factors for ASCVD such as primary care providers, family care providers, cardiologists, endocrinologists and even patients themselves. In fact, there is a resource section designed specifically for patient use.
Neat Features: The app allows the clinician to view the projected impact of different therapy combinations and how these will adjust the ASCVD risk, which is helpful when educating patients on the impact of different therapies.
It also allows users to assess the change in a patient's risk overtime, taking into account initial and follow-up values, which can be a source of encouragement and motivation to many patients.
In addition, there is an email feature that allows providers to create a summary of the calculated ASCVD risk and treatment suggestions, which can be emailed directly to patients or included in the EMR.
Comparable Apps: There are no apps in the Apple or GooglePlay app stores that have this breadth of functionality. There are a small number of other apps which will calculate the 10-year risk of ASCVD, some using the Pooled Cohort Equation and others the Framingham Risk algorithm, but none that have the added capacity to estimate the impact different therapies can be expected to have.
While other apps may reference the ACC/AHA guidelines, none give evidence-based individualized recommendations created from the patient's specific set of risk factors.
Visit ACC.org/Apps to download this app and learn more about ACC's full suite of clinical mobile apps.
This article was written by Hawkins Clark Gay, MD, Fellow in Training (FIT) at Northwestern University in Chicago, IL.