Could a quick online quiz replace the need for broad, costly cardiac screening? A new study published in Heart suggests it just might — at least as a smart first filter. Researchers in Sweden invited 8,000 adults aged 59–60 to complete a 14-item self-report questionnaire designed to predict their likelihood of having significant coronary artery calcium (CAC), a well-established marker of cardiovascular risk. Those flagged as high-risk were then offered a CT scan to confirm.

The results were remarkably accurate: the model predicted a 28.3% prevalence of elevated CAC, and the actual observed rate came in at 28.4% — nearly a perfect match. But perhaps the most striking finding wasn't about the screening tool itself — it was about what happened after: the majority of high-risk individuals weren't receiving adequate preventive treatment.

By the Numbers:

• 2,588 individuals completed the questionnaire; 814 were classified as high risk
• 28.3% predicted vs. 28.4% actual CAC prevalence (ratio: 0.99)
• 64% of those with elevated CAC were not on any lipid-lowering therapy
• Only 8% were on treatment and had LDL cholesterol at target (≤1.8 mmol/L)
• 12.6% of CT scan completers had a CAC score ≥300

Why it matters: This approach offers a low-cost, scalable way to identify people who need cardiac imaging — and more importantly, those who need preventive treatment they're not yet receiving. For primary care providers, it's a potential game-changer in closing the cardiovascular prevention gap.