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European Heart Journal Advance Access originally published online on April 17, 2007
European Heart Journal 2007 28(9):1045-1046; doi:10.1093/eurheartj/ehm084
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Barriers to clinical risk scores adoption

Olivia Manfrini and Raffaele Bugiardini*

Dipartimento di Medicina Interna, Cardioangiologia, Epatologia (Padiglione 11), University of Bologna, Via Massarenti 9, 40138 Bologna, Italy

* Corresponding author. Tel:/fax: +39 (0) 513 47290. E-mail address: raffaele.bugiardini@unibo.it

This editorial refers to ‘Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better’{dagger} by A.T. Yan et al., on page 1072

The first 10% of the full text of this article appears below.

Variability in physician decision-making is evident from recent studies on acute coronary syndrome documenting substantial differences in the use of various cardiac procedures.1 Fundamental to decision-making is the recognition of the most powerful predictors of survival. It is essential for the cardiovascular specialists to attempt and define the appropriate indications for medications and procedures and to base these recommendations on data from clinical research studies whenever possible.

Clinical judgment

The essential feature of clinical judgment is that physicians do not act solely on an evidence basis or on an arbitrary basis. Clinical judgment combines personal clinical experience, published research, patient perspectives, and other insights. Clinical judgment, however, might be a flaw. Common elements that may produce errors include conflicting information, . . . [Full Text of this Article]

Guidelines in clinical practice

Conflicting information

Clinical risk scores may run counter to established rules

Clinical value of the risk scores in patients without obstructive lesions

Additional barriers

Approaches that enhance adoption of risk scores


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Related articles in EHJ:

Risk scores for risk stratification in acute coronary syndromes: useful but simpler is not necessarily better
Andrew T. Yan, Raymond T. Yan, Mary Tan, Amparo Casanova, Marino Labinaz, Kumar Sridhar, David H. Fitchett, Anatoly Langer, and Shaun G. Goodman
EHJ 2007 28: 1072-1078. [Abstract] [Full Text]