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 .
Impact of effectiveness information format on patient choice of therapy and satisfaction with decisions about chronic disease medication: the "Influence of intervention Methodologies on Patient Choice of Therapy (IMPACT)" cluster-randomised trial in general practice
Background Risk communication is an integral part of shared decision-making in health care . In the context of interventions for chronic diseases it represents a particular challenge for all health practitioners . By using two different quantitative formats to communicate risk level and effectiveness of a cholesterol-lowering drug , we posed the research question : how does the format of risk information influence patients ’ decisions concerning therapy , patients ’ satisfaction with the communication as well as confidence in the decision . We hypothesise that patients are less prone to accept therapy when the benefits of long-term intervention are presented in terms of prolongation of life ( POL ) in months compared to the absolute risk reduction ( ARR ) . We hypothesise that patients presented with POL will be more satisfied with the communication and confident in their decision , suggesting underst and ing of the time-related term . Methods / Design In 2009 a sample of 328 general practitioners ( GPs ) in the Region of Southern Denmark was invited to participate in a primary care-based clinical trial among patients making real-life clinical decisions together with their GP . Interested GPs were cluster-r and omised to inform patients about cardiovascular disease ( CVD ) risk and the effectiveness of statin therapy using either POL or ARR . The GPs attended a training session before informing their patients . Before training and after the trial period they received a question naire about their attitudes to risk communication and the use of numerical information . Patients ’ redemptions of statin prescriptions will be registered in a regional prescription data base to evaluate a possible association between redemption rates and effectiveness format . The Combined Outcome Measure for Risk Communication And Treatment Decision Making Effectiveness ( COMRADE ) question naire will be used to measure patients ’ confidence and satisfaction with the risk communication immediately after the conversation with their GPs . Discussion This r and omised clinical trial compares the impact of two effectiveness formats on real-life risk communication between patients and GPs , including affective patient outcomes and actual choices about acceptance of therapy . Though we found difficulties in recruiting GPs , according to the study protocol we have succeeded in engaging sufficient GPs for the trial , enabling us to perform the planned analyses . Trial registration Clinical Trials.gov Protocol Registration System http://ww . clinical
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 .