WarfarinGuide vs CV Risk Estimation

Warfarin Guide offers three resources essential for systematic and careful evidence-based anticoagulation with Warfarin. First it reviews recommendations on indications, INR targets, and treatment duration from the American College of Chest Physicians 8th Edition guidelines on Antithrombotic and Thrombolytic Therapy from 2008, updated for the 2012 guideline. Second it offers a protocol for Warfarin dose adjustment depending upon INR result. And third is a discussion of protocols for the initiation of Warfarin. These resources come from point of care guides on these topics in the family medicine literature as well as the 2012 ACCP guideline. The app also offers guidance for management of peri-operative Warfarin by directing the user to oexcellent comprehensive resources for managing all anticoagulants and antiplatelet agents around surgery. The app addresses such common questions as: •which artificial heart valves require that higher level of anticoagulation? •how do I respond to an INR of 7.4? •this pt needs Warfarin, how do I get it started? •I'm adjusting the total weekly warfarin dose down by 5%, when should I recheck the INR? •when do I give Vitamin K to reverse Warfarin anticoagulation and at what dose?? This app is written and intended for practicing clinicians involved in Warfarin anticoagulation such as internists, cardiologists, family physicians, nurses, pharmacists, PA's and NP's; for resident physician trainees; and for medical students. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.

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.