The changes to the way doctors prescribe cholesterol-lowering statins were described last week as "tectonic" and "profound"; today, the New York Times uses the phrase "major embarrassment." The issue: the online risk calculator introduced by the American Heart Association and the American College of Cardiology to flag candidates for statins may overestimate risk—hugely. The issue was apparently identified a year ago by two Harvard Medical School professors who had reviewed a draft version; their input never made it to those developing the calculator, and the professors noticed the same errors in the final calculator when it was revealed publicly on Tuesday.
The two, Dr. Paul M. Ridker and Dr. Nancy Cook, last week ran the calculator against patient data from three decade-plus-long studies. Their determination: The calculator inflated risk by 75% to 150%. And with the new guidelines stipulating treatment for anyone whose risk is at 7.5%, someone whose risk is actually 3% might appear to hit that threshold; millions could mistakenly qualify for the drugs, notes the Times. On Saturday night, the American Heart Association and the American College of Cardiology held an emergency meeting with Ridker, and emerged saying that Cook and Ridker's findings "merit attention." But the head of the guideline committee called the groups' work "the best efforts of people who have been working for five years" and questioned whether the studies the Ridker and Cook used followed abnormally healthy people. (More cholesterol stories.)
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