There is uncertainty whether current strategies for providing CVD risk scores  affect CVD events .
Providing CVD risk scores may slightly reduce CVD risk factor levels and may increase preventive medication prescribing in higher-risk people without evidence of harm .
BACKGROUND The current paradigm for cardiovascular disease ( CVD ) emphasises absolute risk assessment to guide treatment decisions in primary prevention .
Although the derivation and validation of multivariable risk assessment tools , or CVD risk scores , have attracted considerable attention , their effect on clinical outcomes is uncertain .
OBJECTIVES To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes , risk factor levels , preventive medication prescribing , and health behaviours .
Should Clinicians Deliver Decision Aids? Further Exploration of the Statin Choice Randomized Trial Results
Background . Statin Choice is a decision aid about taking statins . The optimal mode of delivering Statin Choice ( or any other decision aid ) in clinical practice is unknown . Methods . To investigate the effect of mode of delivery on decision aid efficacy , the authors further explored the results of a concealed 2 × 2 factorial clustered r and omized trial enrolling 21 endocrinologists and 98 diabetes patients and r and omizing them to 1 ) receive either the decision aid or pamphlet about cholesterol , and 2 ) have these delivered either during the office visit ( by the clinician ) or before the visit ( by a research er ) . We estimated between-group differences and their 95 % confidence intervals ( CI ) for acceptability of information delivery ( 1—7 ) , knowledge about statins and coronary risk ( 0—9 ) , and decisional conflict about statin use ( 0—100 ) assessed immediately after the visit . Follow-up was 99 % . Results . The relative efficacy of the decision aid v. pamphlet interacted with the mode of delivery . Compared with the pamphlet , patients whose clinicians delivered the decision aid during the office visit showed significant improvements in knowledge ( difference of 1.6 of 9 questions , CI 0.3 , 2.8 ) and nonsignificant trends toward finding the decision aid more acceptable ( odds ratio 3.1 , CI 0.9 , 11.2 ) and having less decisional conflict ( difference of 7 of 100 points , CI -4 , 18 ) than when a research er delivered the decision aid just before the office visit . Conclusions . Delivery of decision aids by clinicians during the visit improves knowledge and shows a trend toward better acceptability and less decisional conflict
There is uncertainty whether current strategies for providing CVD risk scores  affect CVD events .
Providing CVD risk scores may slightly reduce CVD risk factor levels and may increase preventive medication prescribing in higher-risk people without evidence of harm .
BACKGROUND The current paradigm for cardiovascular disease ( CVD ) emphasises absolute risk assessment to guide treatment decisions in primary prevention .
Although the derivation and validation of multivariable risk assessment tools , or CVD risk scores , have attracted considerable attention , their effect on clinical outcomes is uncertain .
OBJECTIVES To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes , risk factor levels , preventive medication prescribing , and health behaviours .