EBM Stats Calc vs CV Risk Estimation

Occasionally in medicine, we really need to "do the math". This app will help. EBM Stats Calc let's a clinician do calculations that are hard or impossible to do in one's head. A clinician can get NNT's (number needed to treat) from rates, percentages, or raw event and patient numbers. And a clinician can use sensitivity and specificity or likelihood ratios (LR+, LR-) to go from a pretest probability to posttest probability and positive predictive value and negative predictive value. Although these calculators themselves are somewhat novel for apps, the unique tool in this app is for educators. Students and residents have a hard time understanding how the utility of a test can vary with pretest probability. Instead of saying it in words and hoping they get it, now you can demonstrate it. A test might perform well, giving good PPV and NPV, when pretest probability is in a certain range. But slide that pretest probability up or down and see the diagnostic utility change with the numbers flying right before your eyes. The tool also shows a student that in many cases, an imprecise estimate of pretest probability doesn't much matter. Different doctors might judge a clinical case to suggest likelihood of disease (pretest probability) of 40%, 50%, or 60%. The slider tool shows that the differences may not matter, and the test in mind will render good clarity regardless of differing opinions on pretest probability. The app is written for clinicians, students, residents, and especially educators, in any discipline of medicine. As a clinician and educator myself, I would be grateful for feedback to make the tool better.

This app is for CLINICIANS, not the lay public. The CV Risk app presents clinicians with three valuable 10-year cardiovascular event risk calculators to serve clinicians and learners in primary prevention of cardiovascular disease. It is for clinicians only, not the lay public. The calculators are Framingham 2008, ASCVD 2013, and the revised pooled cohort equations ASCVD of 2018. The app addresses such common questions as: • What is the ASCVD 10-year CV risk for a 57 year old male hypertensive smoker with a given set of lipid and blood pressure numbers? • What’s the magnitude of impact of a patient on their own improving their cholesterol by 11, 27, or 41 points? • For a poorly controlled hypertensive smoker with a 10-year risk of 31.3%, how impactful would improved blood pressure control or smoking cessation be? • How impactful is a cholesterol of 220 on a given patient's risk at 35 vs. 55 vs. 75 years old? • I hear that ASCVD 2013 overestimates risk, particularly for black adults? True? What about the revised pooled cohort equations of 2018? The app explicitly does not include treatment thresholds, LDL targets, estimates of impact of therapy, coronary calcium scoring, etc. I wanted the cleanest simplest tool possible for evaluating and discussing cardiovascular risk with all the other more subjective, controversial stuff out of the way. This app is written and intended for practicing clinicians like internists and family physicians; for resident physician trainees; for medical students; and of course for other clinician colleagues like NP's and PA's. Cardiologists could use this app, but you folks are focused on secondary prevention, which is an entirely different ballgame. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.