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 .
Presenting risk information to people with diabetes: evaluating effects and preferences for different formats by a web-based randomised controlled trial.
OBJECTIVE Web-based patient information is widespread and information on the benefits and risks of treatments is often difficult to underst and . We therefore evaluated different risk presentation formats - numerical , graphical and others - addressing the pros and cons of tight control versus usual treatment approaches for diabetes . METHOD DESIGN R and omised controlled trial . SETTING Online . Publicity disseminated via Diabetes UK . PARTICIPANTS People with diabetes or their carers . INTERVENTIONS Control group information based on British Medical Journal ' Best Treatments ' . Four intervention groups received enhanced information re sources : ( 1 ) detailed numerical information ( absolute/relative risk , numbers-needed-to-treat ) ; ( 2 ) ' anchoring ' to familiar risks or descriptions ; ( 3 ) graphical ( bar charts , thermometer scales , crowd figure formats ) ; ( 4 ) combination of 1 - 3 .  OUTCOMES Decision conflict scale ( DCS , a measure of uncertainty ) ; satisfaction with information ; further free text responses for qualitative content analysis . RESULTS Seven hundred and ten people visited the website and were r and omised . Five hundred and eight completed the question naire for quantitative data . Mean DCS scores ranged from 2.12 to 2.24 for the five r and omisation groups , indicating neither clear delay or vacillation about decisions ( usually DCS>2.5 ) nor tending to make decisions ( usually DCS<2.0 ) . There were no statistically significant effects of the interventions on DCS , or satisfaction with information .  Two hundred and fifty-six participants provided responses for qualitative analysis : most found graphical representations helpful , specifically bar chart formats ; many found other graphic formats ( thermometer style , crowd figures/smiley faces ) and ' anchoring ' information unhelpful , and indicated information overload . Many negative experiences with healthcare indicate a challenging context for effective information provision and decision support . CONCLUSION Online evaluation of different risk representation formats was feasible . There was a lack of intervention effects on quantitative outcomes , perhaps reflecting already well-informed participants from the Diabetes UK patient organisation . The large qualitative data set included many comments about what participants found helpful as formats for communicating risk information . PRACTICE IMPLICATION S These findings assist the design of online decision aids and the representation of risk information . The challenge is to provide more information , in appropriate and clear formats , but without risking information overload . Interactive web design s hold much promise to achieve this
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 .