Insights from Dr. Gregory Lip, Creator of the CHA2DS2-VASc Score

The CHA2DS2-Vasc Score is one of the most widely-used clinical risk scores for stroke. It’s arguably the best validated and is consistently in the top five most popular calcs on MDCalc. Professor Gregory Lip, the newest member of MDCalc’s Scientific Advisory Board, gave us an interview on developing and using the CHA₂DS₂-VASc Score.

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Dr. Gregory Lip

Why did you develop the CHA₂DS₂-VASc Score? Was there a clinical experience that inspired you to create this tool for clinicians?

The availability of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs), previously referred to as new or novel oral anticoagulants, has led to a major change in the landscape for stroke prevention in atrial fibrillation (AF). Clinicians are also getting better at understanding how to manage warfarin, recognizing the importance of the average time in therapeutic range (TTR). New data are also re-emerging on the poor evidence for the efficacy and safety of aspirin for stroke prevention in AF. Continue reading “Insights from Dr. Gregory Lip, Creator of the CHA2DS2-VASc Score”

Insights from Dr. William Knaus, Creator of the APACHE II Score

The APACHE II Score is the most-referenced risk score for ICU mortality, with over 15,000 citations in PubMed since its publication 22 years ago, and is still used today both clinically and in research. We talked with Dr. William Knaus, first author on the APACHE paper, about his experience in developing the APACHE II Score, as well as the increasing need for technology in healthcare (and its disappointing uptake and implementation).

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Dr. William Knaus

When we started [developing APACHE] in the 1970s, DRGs [diagnosis-related groups] were just coming on the scene, and obviously they were oriented towards the business and financing aspects of healthcare. There’s little correlation to the clinical. But people were relying on DRGs as a way to classify and identify patients, especially in the ICU. So it was important at that time to not so much reinvent the diagnostic system, but to talk about how patients come in at different levels of severity. And at that time, there was really nothing out there. Continue reading “Insights from Dr. William Knaus, Creator of the APACHE II Score”

Don’t Forget the Zebras: Familial Hypercholesterolemia

Did you know that FH is very treatable but missed in 90% of cases, and leads to early cardiac death? We’ve added some calculators to try to address it:

Unless you’re an endocrinologist, FH is one of those diseases you probably memorized in medical school, brought up on rounds when the Continue reading “Don’t Forget the Zebras: Familial Hypercholesterolemia”