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 .
The effect of a patient-oriented treatment decision aid for risk factor management in patients with diabetes (PORTDA-diab): study protocol for a randomised controlled trial
Background To improve risk factor management in diabetes , we need to support effective interactions between patients and healthcare providers . Our aim is to develop and evaluate a treatment decision aid that offers personalised information on treatment options and outcomes , and is intended to empower patients in taking a proactive role in their disease management . Important features are : ( 1 ) involving patients in setting goals together with their provider ; ( 2 ) encourage them to prioritise on treatments that maximise relevant outcomes ; and ( 3 ) integration of the decision aid in the practice setting and workflow . As secondary aim , we want to evaluate the impact of different presentation formats , and learn more from the experiences of the healthcare providers and patients with the decision aid . Methods and design We will conduct a r and omised trial comparing four formats of the decision aid in a 2 × 2 factorial design with a control group . Patients with type 2 diabetes managed in 18 to 20 primary care practice s in The Netherl and s will be recruited . Excluded are patients with a recent myocardial infa rct ion , stroke , heart failure , angina pectoris , terminal illness , cognitive deficits , > 65 years at diagnosis , or not able to read Dutch . The decision aid is offered to the patients immediately before their quarterly practice consultation . The same decision information will be available to the healthcare provider for use during consultation . In addition , the providers receive a set of treatment cards , which they can use to discuss the benefits and risks of different options . Patients in the  control group will receive care as usual . We will measure the effect of the intervention on patient empowerment , satisfaction with care , beliefs about medication , negative emotions , health status , prescribed medication , and predicted cardiovascular risk . Data will be collected with question naires and automated extraction from medical records in 6 months before and after the intervention . Discussion This decision aid is innovative in supporting patients and their healthcare providers to make shared decisions about multiple treatments , using the patient ’s data from electronic medical records . The results can contribute to the further development and implementation of electronic decision support tools for the management of chronic diseases . Trial registration Dutch Trial register NTR1942
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 .