ArticleBMC health services research2003
Physicians' ability to predict the risk of coronary heart disease.
Article in BMC health services research, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Risk factors for small vessel disease in adults with atherosclerosis: a systematic review and meta-analysis.BMC cardiovascular disorders · 2026Pooled it
- Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2017Pooled it
- Does the routine use of global coronary heart disease risk scores translate into clinical benefits or harms? A systematic review of the literature.BMC health services research · 2008Pooled it
- Trial
- Clinical decision support directed to primary care patients and providers reduces cardiovascular risk: a randomized trial.Journal of the American Medical Informatics Association : JAMIA · 2018Trial
- Providing clinicians with a patient's 10-year cardiovascular risk improves their statin prescribing: a true experiment using clinical vignettes.BMC cardiovascular disorders · 2013Trial
- Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2026Article
- The effects of atherosclerotic cardiovascular disease and ten-year atherosclerotic cardiovascular disease risk score on mental health status.Scientific reports · 2026Article
- Prediction of fractional flow reserve with enhanced ant lion optimized support vector machine.Heliyon · 2023Article
- A highly predictive cardiac positron emission tomography (PET) risk score for 90-day and one-year major adverse cardiac events and revascularization.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Atherosclerotic cardiovascular disease risk assessment: An American Society for Preventive Cardiology clinical practice statement.American journal of preventive cardiology · 2022Article
- Cardiovascular risk assessment: The foundation of preventive cardiology.American journal of preventive cardiology · 2020Review
- Cardiovascular Disease and Mortality in Adults Aged ≥60 Years According to Recommendations by the American College of Cardiology/American Heart Association and American College of Physicians/American Academy of Family Physicians.Hypertension (Dallas, Tex. : 1979) · 2019Article
- Benefits, harms and evidence - reflections from UK primary healthcare.London journal of primary care · 2018Article
- Using Predicted Cardiovascular Disease Risk in Conjunction With Blood Pressure to Guide Antihypertensive Medication Treatment.Journal of the American College of Cardiology · 2017Review
- Cardiovascular risk assessment: a global perspective.Nature reviews. Cardiology · 2015 · on this mapReview
- Do clinicians recommend aspirin to patients for primary prevention of cardiovascular disease?Journal of general internal medicine · 2015Article
- The effect of a decision aid intervention on decision making about coronary heart disease risk reduction: secondary analyses of a randomized trial.BMC medical informatics and decision making · 2014Article
- Adding a life-course perspective to cardiovascular-risk communication.Nature reviews. Cardiology · 2013Review
- Use of global coronary heart disease risk assessment in practice: a cross-sectional survey of a sample of U.S. physicians.BMC health services research · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary heart disease (CHD) is the leading cause of death in the United States. Previous research examining physicians ability to estimate cardiovascular risk has shown that physicians' generally overestimate the absolute risk of CHD events. This question has, however, only studied risk prediction for a limited number of patient care scenarios. The aim of this study is to measure the ability of physicians to estimate the risk of CHD events in patients with no previous history of coronary heart disease.
methodsTwelve primary prevention scenarios with a 5-year risk of CHD events were developed. This questionnaire was surveyed at 3 university teaching hospitals where the participants were a convenience sample of internal medicine residents and fellows or attending physicians in general internal medicine or cardiology. For each scenario, physicians were asked to estimate the baseline 5-year risk of a coronary heart disease event and the revised risk if the patient were to receive lipid-lowering drug therapy. Estimates of the baseline 5-year risk were compared with values calculated from Framingham risk equations. Inaccurate responses were defined as those with a ratio of estimated to actual risk of more than 1.5 or less than 0.67. Physicians' estimates of the relative risk reduction with therapy were considered to be accurate if they were between 25% and 40%.
results79 physicians (53 residents, 8 fellows, 18 attending physicians) completed the survey. Only 24% of physicians' risk estimates were accurate. In most cases, physicians overestimated the absolute risk of cardiovascular events without therapy (proportion overestimating ranged from 32-92% for the 12 individual scenarios). Physicians made larger errors in patient scenarios involving patients with high total or LDL cholesterol levels. Physicians' estimates of the relative risk reduction from treatment were more accurate: 43% of estimates were between 25 and 40%. Over 85% of physicians recommended treatment in 10 of 12 scenarios.
conclusionsPhysicians overestimate the absolute risk of CHD events and the potential absolute benefit of drug therapy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.