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The Guardian (GUidelines for cARDIovasculAr risk implemeNted through an interactive computerized access ) software represents an interactive implementation of World Health Organization 2007 guidelines for the assessment and management of cardiovascular risk.It provides a user friendly way for: 1. management and assessment of cardiovascular risk, by using the 2007 World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts tailored for 14 world subregions 2. evidence-based guidance on how to reduce this riskGuardian Risk Calculator is available for download.Risk Calculator featuresGuardian comes with preinstalled risk prediction charts used to estimate the cardiovascular risk for 14 WHO epidemiological sub-regions.Generates recommendations for prevention of cardiovascular disease in people with risk factorsGenerates recommendations for prevention of recurrent CHD (heart attack) and CeVD (stroke) events without the use of prediction charts. The secondary prevention recommendations are based only on clinical conditions (i.e. previous CHD or CeVD events)Completely localizable and with full i18n supportBoth recommendations and application strings are stored in external UTF-16 fileShipped with embedded SQLite database engineThe acquired informations are stored in a standard SQLite database in user reachable location.Save and PrintSave your data for future reference and print generated reports.IMPLEMENTATION OF WHO CARDIOVASCULAR RISK GUIDELINES IN DEVELOPING COUNTRIES THROUGH AN INTERACTIVE, COMPUTER-BASED ACCESSBackgroundNon-communicable diseases (and particularly cardiovascular diseases) are getting one the of the leading causes of invalidity and mortality in developing countries, representing both a social and an economical heavy burden, given the limited resources availability. A careful application of validated and customized guidelines may represent an effective way of facing this problem, facilitating an optimized fund allocation by promoting a profitable shift of funds from the treatment of acute diseases and their sequelae to prevention strategies. In these settings, the widespread implementation of guidelines possibly represents the most problematic task, due to a troublesome diffusion of information, besides to the possible presence of cultural mistrusts. Recently, the World Health Organization produced new guidelines for the management of cardiovascular risk, based on epidemiological surveys performed in 14 different subregions, allowing the calculation of individual 10-year absolute cardiovascular risk scores.Aim of this project is: * To develop an interactive, computer based access to the recently released World Health Organization’s “Prevention of cardiovascular disease: guideline for assessment and management of cardiovascular risk”. * To evaluate the feasibility and, subsequently, the effectiveness of this tool in increasing the diffusion and the adherence to standardized guidelines in some developing countries.Project 1. The program will be tested in a maximum of five developing countries (to be chosen jointly by the WHO / CNR Institute of Clinical Physiology working group), selected on the basis of hardware availability and feedback reliability. Even if a multi-language tool will be eventually produced in the future (ideally comprising English, French, Spanish, Portuguese, Arabic and Chinese versions), the initial group of testing countries will be chosen in order to minimize the need of translation (a maximum of three versions in different languages, to be chosen among English, French, Spanish, Portuguese, will be provided). 2. The interactive, computer-based access to WHO guidelines will be based on a two-stages software. First, selected anamnestic and clinical data are requested by a standardized questionnaire and inserted in a risk calculator, to obtain the individual 10-year absolute cardiovascular risk. Afterwards, a customized plan to reduce cardiovascular risk (based on both lifestyle changes and drug prescription) is obtained and supplied to patient. 3. The feasibility of this approach will be evaluated by a standardized questionnaire, dedicated to sanitary personnel, aiming to assess both the friendliness and the perceived usefulness of the tool. 4. Indicators of effectiveness (number of subjects treated for hypertension, diabetes and dyslipidemia, blood pressure values and, where available, cholesterol and glucose blood levels, mean risk score at subsequent ambulatory evaluation) will be obtained, during a 6-12 months trial, and compared both to historical data collected in the same area during the 6 months preceding the trial and to data collected in neighborhood areas not submitted to the trial. 5. A wider and longer lasting test will be eventually set-up after the analysis of the first trial previously outlined.
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