App calculates risk, reward for patients using aspirin

Researchers at Brigham and Women's Hospital have developed a mobile app called "Aspirin-Guide" that is able to calculate the cardiovascular disease risk and the bleeding risk scores for patients while helping clinicians decide which patients are appropriate candidates for the use of low dose aspirin.

"We developed the Aspirin-Guide app because we realized that weighing the risks and benefits of aspirin for individuals who have not had a heart attack or stroke is a complex process. The new mobile app enables individualized benefit to risk assessment in a matter of seconds while the patient is with the physician," said Samia Mora, MD, cardiologist at BWH.

Low doses of aspirin are recommended to patients that have already suffered a heart attack or stroke. Physicians have to weigh prevention of a cardiovascular disease to the increased risk of gastrointestinal or other internal bleeding.

The app helps patients and physicians by calculating a number of factors, personalized by each patient including:

• Calculating a 10-year cardiovascular disease risk score (heart disease and stroke) for the patient.
• Calculating a bleeding risk score based on the patient's individual risk factors.
• Using evidence from the literature, together with the above scores, to compare the number needed to treat vs. the number needed to harm.
• Helping clinicians to implement current clinical guidelines for low-dose aspirin in primary prevention.
• Provides the ability to email a summary of the decision-making process to the patient and/or to the clinician for the patient's record.

"Aspirin-Guide is a user-friendly clinical decision support tool, that will facilitate informed and personalized decision-making about the use of aspirin in primary prevention of CVD. Patients should discuss the pros and cons of aspirin treatment with their healthcare provider," said JoAnn Manson, MD, cardiovascular epidemiologist and Chief of Preventive Medicine at BWH.