BACKGROUND: Global coronary heart disease (CHD) risk estimation (ie, a quantitative estimate of a patient's chances of CHD calculated by combining risk factors in an empirical equation) is recommended as a starting point for primary prevention efforts in all US adults. Whether it improves outcomes is currently unknown. METHODS: To assess the effect of providing global CHD risk information to adults, we performed a systematic evidence review. We searched MEDLINE for the years 1980 to 2008, Psych Info, CINAHL, and the Cochrane Database and included English-language articles that met prespecified inclusion criteria. Two reviewers independently reviewed titles, abstracts, and articles for inclusion and assessed study quality. RESULTS: We identified 20 articles, reporting on 18 unique fair or good quality studies (including 14 randomized controlled studies). These showed that global CHD risk information alone or with accompanying education increased the accuracy of perceived risk and probably increased intent to start therapy. Studies with repeated risk information or risk information and repeated doses of counseling showed small significant reductions in predicted CHD risk (absolute differences, -0.2% to -2% over 10 years in studies using risk estimates derived from Framingham equations). Studies providing global risk information at only 1 point in time seemed ineffective. CONCLUSIONS: Global CHD risk information seems to improve the accuracy of risk perception and may increase intent to initiate CHD prevention among individuals at moderate to high risk. The effect of global risk presentation on more distal outcomes is less clear and seems to be related to the intensity of accompanying interventions.
BACKGROUND: Global coronary heart disease (CHD) risk estimation (ie, a quantitative estimate of a patient's chances of CHD calculated by combining risk factors in an empirical equation) is recommended as a starting point for primary prevention efforts in all US adults. Whether it improves outcomes is currently unknown. METHODS: To assess the effect of providing global CHD risk information to adults, we performed a systematic evidence review. We searched MEDLINE for the years 1980 to 2008, Psych Info, CINAHL, and the Cochrane Database and included English-language articles that met prespecified inclusion criteria. Two reviewers independently reviewed titles, abstracts, and articles for inclusion and assessed study quality. RESULTS: We identified 20 articles, reporting on 18 unique fair or good quality studies (including 14 randomized controlled studies). These showed that global CHD risk information alone or with accompanying education increased the accuracy of perceived risk and probably increased intent to start therapy. Studies with repeated risk information or risk information and repeated doses of counseling showed small significant reductions in predicted CHD risk (absolute differences, -0.2% to -2% over 10 years in studies using risk estimates derived from Framingham equations). Studies providing global risk information at only 1 point in time seemed ineffective. CONCLUSIONS: Global CHD risk information seems to improve the accuracy of risk perception and may increase intent to initiate CHD prevention among individuals at moderate to high risk. The effect of global risk presentation on more distal outcomes is less clear and seems to be related to the intensity of accompanying interventions.
Authors: Eugene Z Oddone; Jennifer M Gierisch; Linda L Sanders; Angela Fagerlin; Jordan Sparks; Felicia McCant; Carrie May; Maren K Olsen; Laura J Damschroder Journal: J Gen Intern Med Date: 2018-05-07 Impact factor: 5.128
Authors: David C Goff; Donald M Lloyd-Jones; Glen Bennett; Sean Coady; Ralph B D'Agostino; Raymond Gibbons; Philip Greenland; Daniel T Lackland; Daniel Levy; Christopher J O'Donnell; Jennifer G Robinson; J Sanford Schwartz; Susan T Shero; Sidney C Smith; Paul Sorlie; Neil J Stone; Peter W F Wilson; Harmon S Jordan; Lev Nevo; Janusz Wnek; Jeffrey L Anderson; Jonathan L Halperin; Nancy M Albert; Biykem Bozkurt; Ralph G Brindis; Lesley H Curtis; David DeMets; Judith S Hochman; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Sidney C Smith; Gordon F Tomaselli Journal: Circulation Date: 2013-11-12 Impact factor: 29.690
Authors: Beverly B Green; Melissa L Anderson; Andrea J Cook; Sheryl Catz; Paul A Fishman; Jennifer B McClure; Robert J Reid Journal: Am J Prev Med Date: 2014-04 Impact factor: 5.043
Authors: Nicolas Rodondi; Reto Auer; Vanessa de Bosset Sulzer; William A Ghali; Jacques Cornuz Journal: J Gen Intern Med Date: 2011-09-01 Impact factor: 5.128
Authors: Beverly B Green; Melissa L Anderson; Andrea J Cook; Sheryl Catz; Paul A Fishman; Jennifer B McClure; Robert Reid Journal: Am J Prev Med Date: 2012-04 Impact factor: 5.043
Authors: Mori J Krantz; Stephanie M Coronel; Elizabeth M Whitley; Rita Dale; Jason Yost; Raymond O Estacio Journal: Am J Public Health Date: 2012-11-15 Impact factor: 9.308
Authors: Kevin Fiscella; Paul C Winters; Michael Mendoza; Gary J Noronha; Carlos M Swanger; John D Bisognano; Robert J Fortuna Journal: J Gen Intern Med Date: 2015-02 Impact factor: 5.128
Authors: Cherry-Ann Waldron; John Gallacher; Trudy van der Weijden; Robert Newcombe; Glyn Elwyn Journal: BMC Med Inform Decis Mak Date: 2010-07-30 Impact factor: 2.796
Authors: Valery L Feigin; Bo Norrving; Mary G George; Jennifer L Foltz; Gregory A Roth; George A Mensah Journal: Nat Rev Neurol Date: 2016-07-22 Impact factor: 42.937