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Objectives: To evaluate the performance of the 2013 Pooled Cohort Risk Equation (PCE-ASCVD) for predicting cardiovascular disease (CVD) in an Australian population; to compare this performance with that of three frequently used Framingham-based CVD risk prediction models.Design: Prospective national population-based cohort study.Setting: 42 randomly selected urban and non-urban areas in six Australian states and the Northern Territory.Participants: 5453 adults aged 40-74 years enrolled in the Australian Diabetes, Obesity and Lifestyle study and followed until November 2011. We excluded participants who had CVD at baseline or for whom data required for risk model calculations were missing.Main Outcome Measures: Predicted and observed 10-year CVD risks (adjusted for treatment drop-in); performance (calibration and discrimination) of four CVD risk prediction models: 1991 Framingham, 2008 Framingham, 2008 office-based Framingham, 2013 PCE-ASCVD.Results: The performance of the 2013 PCE-ASCVD model was slightly better than 1991 Framingham, and each was better the two 2008 Framingham risk models, both in men and women. However, all four models overestimated 10-year CVD risk, particularly for patients in higher deciles of predicted risk. The 2013 PCE-ASCVD (7.5% high risk threshold) identified 46% of men and 18% of women as being at high risk; the 1991 Framingham model (20% threshold) identified 17% of men and 2% of women as being at high risk. Only 16% of men and 11% of women identified as being at high risk by the 2013 PCE-ASCVD experienced a CV event within 10 years.Conclusions: The 2013 PCE-ASCVD or 1991 Framingham should be used as CVD risk models in Australian. However, the CVD high risk threshold for initiating CVD primary preventive therapy requires reconsideration. [ABSTRACT FROM AUTHOR]

The article discusses the research which shows the number of children in Australia with health problems identified by the Healthy Kids Check (HKC). It states that research used medical records audit from two general practices in Queensland. It notes that most children in the sample had no problems detected in medical record, while 21 percent had problems during HKC assessment. It mentions that general practitioners are diligent in detecting and management of child health problems.

The article offers information related to the prevention of cardiovascular disease. The absolute risk is calculated in the Australian National Vascular Disease Prevention Alliance (NVDPA) as the probability of a stroke. The Pharmaceutical Benefits Scheme (PBS) was revised by the Pharmaceutical Benefits Advisory Committee (PBAC) in 2006. The absolute risk must be monitored after making management decisions.

Several letters to the editor and a reply are presented regarding the article "Primary prevention of cardiovascular disease: new guidelines," by M. R. Nelson and J. A. Doust in the 2013 issue.

Objectives: To elicit the views of well informed community members on the ethical obligations of general practitioners regarding prostate-specific antigen (PSA) testing, and what should be required before a man undergoes a PSA test.Design and Setting: Three community juries held at the University of Sydney over 6 months in 2014.Participants: Forty participants from New South Wales, of diverse social and cultural backgrounds and with no experience of prostate cancer, recruited through public advertising: two juries of mixed gender and ages; one all-male jury of PSA screening age.Results: In contrast to Royal Australian College of General Practitioners guidelines, the three juries concluded that GPs should initiate discussions about PSA testing with asymptomatic men over 50 years of age. The mixed juries voted for GPs offering detailed information about all potential consequent benefits and harms before PSA testing, and favoured a cooling-off period before undertaking the test. The all-male jury recommended a staggered approach to providing information. They recommended that written information be available to those who wanted it, but eight of the 12 jurors thought that doctors should discuss the benefits and harms of biopsy and treatment only after a man had received an elevated PSA test result.Conclusions: Informed jury participants preferred that GPs actively supported individual men in making decisions about PSA testing, and that they allowed a cooling-off period before testing. However, men of screening age argued that uncertain and detailed information should be communicated only after receiving an elevated PSA test result. [ABSTRACT FROM AUTHOR]