Evidence map›Paper›PMID 18691228›Full record

Trial reportInternational journal of clinical practice2008

A novel programme to evaluate and communicate 10-year risk of CHD reduces predicted risk and improves patients' modifiable risk factor profile.

J S Benner, L Erhardt, M Flammer, R A Moller, N Rajicic, K Changela, C Yunis, S B Cherry, Z Gaciong, E S Johnson and 4 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of clinical practice, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  3. Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2017
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  7. Effectiveness of general practice-based health checks: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

J S BennerCenter for Clinical Epidemiology & Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. jbenner@post.harvard.edu
L Erhardt
M Flammer
R A Moller
N Rajicic
K Changela
C Yunis
S B Cherry
Z Gaciong
E S Johnson
M C J M Sturkenboom
J García-Puig
X Girerd
REACH OUT Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsWe assessed whether a novel programme to evaluate/communicate predicted coronary heart disease (CHD) risk could lower patients' predicted Framingham CHD risk vs. usual care.

methodsThe Risk Evaluation and Communication Health Outcomes and Utilization Trial was a prospective, controlled, cluster-randomised trial in nine European countries, among patients at moderate cardiovascular risk. Following baseline assessments, physicians in the intervention group calculated patients' predicted CHD risk and were instructed to advise patients according to a risk evaluation/communication programme. Usual care physicians did not calculate patients' risk and provided usual care only. The primary end-point was Framingham 10-year CHD risk at 6 months with intervention vs. usual care.

resultsOf 1103 patients across 100 sites, 524 patients receiving intervention, and 461 receiving usual care, were analysed for efficacy. After 6 months, mean predicted risks were 12.5% with intervention, and 13.7% with usual care [odds ratio = 0.896; p = 0.001, adjusted for risk at baseline (17.2% intervention; 16.9% usual care) and other covariates]. The proportion of patients achieving both blood pressure and low-density lipoprotein cholesterol targets was significantly higher with intervention (25.4%) than usual care (14.1%; p < 0.001), and 29.3% of smokers in the intervention group quit smoking vs. 21.4% of those receiving usual care (p = 0.04).

conclusionsA physician-implemented CHD risk evaluation/communication programme improved patients' modifiable risk factor profile, and lowered predicted CHD risk compared with usual care. By combining this strategy with more intensive treatment to reduce residual modifiable risk, we believe that substantial improvements in cardiovascular disease prevention could be achieved in clinical practice.

Indexed as

Cardiovascular AgentsClinical ProtocolsCluster AnalysisCommunicationCoronary DiseaseDeath, Sudden, CardiacFemaleHumansMaleMiddle AgedMyocardial InfarctionPrognosisProspective StudiesRisk AssessmentRisk FactorsWeight LossCardiovascular Agents

Identifiers

PMID18691228
PMCPMC2658032

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Registered trials

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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.