= QRisk recalculation discussion

== Issues

1. Missing Hypertension codes

    I (RB) am still unclear which coding system is being used.  Therefore I am going to submit the codes from DM+D, Read CTV3, ATC code and BNF code and see what comes back.

2. Missing Diabetes Type 1 codes

    The paper in the BMJ says that the QRisk2 algorithm uses a diagnosis of diabetes type 1, but not type 2.  However, the QRisk2 batch processor accepts a parameter for diabetes type 1 and this affects the result.  Therefore, I (RB) have got to submit the Type 1 codes above, but keep them separated.

    I have sought clarification from Stephen Hippisley-Cox at ClinRisk about why this requirement has changed. 

3. Missing Similar Codes

    It has become clear that we need to expand the codes used to define certain values (eg, blood pressure) to include other codes that we have yet been requesting.  This will have to be done by manually searching the Read Code hierarchy.

    I have asked Sarah-Jane to post a question on the SystemOne User Forum to see if we can get a definitive list of codes that are used.

    I have been sent a link to the codes that ClinRisk suggest by Stephen Hippisley-Cox.  http://qrisk.org/QRISK2-2013-Code-Lists.pdf

4. Historic diagnosis

    I think that we need to ignore the ''window'' when it comes to diagnoses.  This needs to be confirmed by Prof.

5. Differing versions of the QRisk2 algorithm

    Sarah-Jane has posted a question on the SystemOne user forum asking which version they use.

6. Discrepancies between SystemOne and ClinRisk QRisk2 calculation tools

    The SystemOne QRisk2 calculation tool has some differences to the ClinRisk tool.  Instead of separating diabetes into types 1 and 2, it just has a tick box for diabetes.  Also, it has a tick box for 'personal history of CVD' that is not present on the ClinRisk QRisk2 calculations tools.

    I have asked Sarah-Jane to post a question on the SystemOne user forum asking what differences this will make to the result.

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