Performance of WHO-Updated Cardiovascular Disease Risk Prediction Charts among Doctors: Findings from a Tertiary Care Teaching Center in Puducherry, India

Abstract

Background: The cardiovascular disease (CVD) risk prediction charts, updated by the World Health Organization for 21 regions in 2019. These charts—lab and non-lab versions—estimate a person’s overall CVD risk; the non-lab version is intended for low-resource environments. Objectives: Using the “non-lab” and “lab” versions of the WHO CVD risk prediction charts, we sought to estimate the burden of ten-year risk of a fatal or non-fatal CVD event in a tertiary care hospital of Puducherry and to assess the agreement between them. Materials and Methods: We included 255 doctors working in a tertiary care hospital in Puducherry. Age, gender, systolic blood pressure, and smoking status are all factors used in both charts. Moreover, a lab chart requires a person’s total cholesterol and diabetes mellitus status, whereas a non-lab chart requires a person’s body mass index. Proportions (95% confidence intervals) were used to portray the population at various CVD risk levels. Using Cohen’s Kappa, the degree of agreement between the lab and non-lab charts was assessed (k). Results: The majority of the study participants had 20% in both the charts, which shows the better health-seeking behaviour of doctors. A good level of agreement was shown by the 95.2% (95%CI = 91.7 – 97.4 ) concordance in the risk categorization between the two charts (k = 0.934). Conclusion: When data are available and there is strong agreement between non-lab and lab-based charts, it is practical to apply WHO-updated CVD risk prediction charts.

Keywords

• agreement
• cardiovascular disease
• physician health
• world health organization-ish risk chart