Lifting and hypercholesterolemia

[Marenghi]

Originally Posted by Pluripotent View Post
Personally, I think the ASCVD Risk Estimator is a poor indicator of when to start statins.

I agree.

Austin, Pluripotent, could you say why? And could you refer to a better calculation? Thx!

[Elephant]

But in someone with high risk where the small changes to inputs result in large changes in output risk calculations, arguing that the prescription is inappropriate because the nurse was talking to the patient while measuring their blood pressure is a bit silly IMO.

That seems reasonable, assuming the ASCVD is a reasonable tool. I wonder if you and Pluripotent are in sync on the latter issue.

Assuming 1) they were "true" fasting blood sugars, and 2) you had several data points in that range, I would rely more on the fasting blood sugar over an A1c measurement. If your routine FBG is in fact 120, you are not "fine".

FWIW, a relative measured high on A1c (indicating prediabetes) and the doctor ordered a FBG test (to be repeated periodically), regarding it as more reliable, saying the A1c test is essentially a convenient proxy for FBG tests.

[Pluripotent]

I don't think the ASCVD calculator is a good tool.

[Kiril]

No calculator can substitute a good physician, sorry for being too obvious. And anyway, medicine is not an exact science.

[Elephant]

But in someone with high risk where the small changes to inputs result in large changes in output risk calculations, arguing that the prescription is inappropriate because the nurse was talking to the patient while measuring their blood pressure is a bit silly IMO.

Let me rephrase my prior response to this.

How are you determining high risk? If a patient is genuinely at high risk, then small changes in BP readings due to poor technique should not have a major impact of the decision to prescribe. However, if the ASCVD risk estimator is not a good tool for determining risk and a doctor is prescribing statins due to the risk estimator's recommendation, then we might have a patient who is not genuinely at high risk and therefore the prescription is inappropriate. In this case, small changes in BP readings could have been a deciding factor in an inappropriate prescription.

[Marenghi]

No calculator can substitute a good physician, sorry for being too obvious. And anyway, medicine is not an exact science.

Coming from Isreal, you should know better.

Read Kahneman and Ariely.

[Kiril]

Coming from Isreal, you should know better.

Read Kahneman and Ariely.

I'll read, if you be more precise.

[Mark Rippetoe]

All of it, Kiril. Catch up with Marangue.

[Marenghi]

I'll read, if you be more precise.

Long and boringly written, but comprehensive and by (one of the two) pioneering figures: "Thinking slow, thinking fast".

Crisper: "Predictibly irrational."

Academic: "Decision-making", "behavioral economics", "cognitive biases", "heuristics".

For the lunch break: Videos, for example TED Talk, Ariely on "control of our decisions".

@Rip: One variation you havent tried yet is "Merengue".

[Alchemist]

@Rip: One variation you havent tried yet is "Merengue".

Has Meringue been used?