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Let us next examine the impact
that the Framingham Heart

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Study had through the years.

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So the graph on the
right shows the number

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of papers written
every year using data

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from the Framingham Study
as a function of time,

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and we observe the very
significant increase

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in the number of
such publications.

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Altogether, there has
been 2,400 studies

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written using the
Framingham data.

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During the years, many other
risk factors were evaluated.

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Obesity, exercise,
psychological,

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and social issues.

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In fact, the Texas
Heart Institute Journal

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named the Framingham Heart
Study as the top 10 cardiology

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advance of the 20th century.

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In addition to the
study, there has

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been an online
tool that assesses

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the risk for your 10-year
risk of having a heart attack.

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So you input in this online
tool your age, your gender,

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the total cholesterol,
the HDL cholesterol,

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whether or not you are a smoker,
the systolic blood pressure,

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and then it calculates
your 10-year risk.

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So how about new research
directions and challenges

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that the study is facing?

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So currently, we are in
the third generation that

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started in 2002, but there
was also a second generation

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study of people
enrolled in 1971,

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and the third started in 2002.

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As a result, this
enables the study

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to examine family
history as a risk factor.

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More diverse cohorts
started in 1994 and 2003.

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In addition to the classical
measures we have used so far,

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social network analysis
of the participants

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has also been utilized.

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And additionally and
quite importantly,

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genome -wide association study
is underway linking genetics

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to heart conditions
as a risk factor.

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Of course, many challenges
are related to funding.

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Funding cuts in 1969
nearly closed the study,

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and the 2013 sequester
is threatening

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to close the study as well.

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A very important impact of
the Framingham Heart Study

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is the development of
clinical decision rules.

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The early work on the
study paved the way

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for clinical decision
rules as it is done today.

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And the graph shows the
clinical prediction rules

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published as a function of
the year from 1960s to today.

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And you observe that more
than 70,000 published rules,

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clinical decision rules, have
been published across medicine,

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and you observe that the rate
of publication is increasing.

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So these clinical
decision rules are

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developed using patient and
disease characteristics,

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and then observed test
results from patients

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that can assess the
effectiveness of such rules.