Trial reportJournal of general internal medicine2013
Electronic health record-based patient identification and individualized mailed outreach for primary cardiovascular disease prevention: a cluster randomized trial.
Trial report in Journal of general internal medicine, 2013. The graph read 2 numbers from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. It is linked to 2 registered trials, which are not on this map. Cited by 29 papers, 6 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.
Read, but not usablea number the graph found but could not read as for or against
There was no difference in the primary outcome (11.0 % vs. 11.1 %, OR 0.99, 95 % CI 0.56-1.74, P = 0.96), but intervention group patients were twice as likely to receive a prescription for lipid-lowering medication (11.9 %, vs. 6.0 %, OR 2.13, 95 % CI 1.05-4.32, p = 0.038).
There was no difference in the primary outcome (11.0 % vs. 11.1 %, OR 0.99, 95 % CI 0.56-1.74, P = 0.96), but intervention group patients were twice as likely to receive a prescription for lipid-lowering medication (11.9 %, vs. 6.0 %, OR 2.13, 95 % CI 1.05-4.32, p = 0.038).
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
Antihypertensives×lipids
No readable resultOpen on the map →What to test next →2 readable studies in this cell: 2 favour the treatment, 0 find no difference, 0 favour the comparator.
This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.
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.
Tailored Communication to Reduce Cardiovascular Risk
Effects of Manually Recorded or Automatically Transmitted Home Blood Pressures With or Without Automated Patient Feedback on Hypertension Care
Who cites it
29 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Cardiovascular disease risk communication and prevention: a meta-analysis.European heart journal · 2024Pooled it
- Strategies to improve smoking cessation rates in primary care.The Cochrane database of systematic reviews · 2021Pooled it
- Pooled it
- Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2017Pooled it
- Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review.BMJ open · 2016Pooled it
- Impact of provision of cardiovascular disease risk estimates to healthcare professionals and patients: a systematic review.BMJ open · 2015Pooled it
- Sustainability of an electronic technology-based intervention in general practice targeting improved detection and monitoring of the interrelated chronic vascular diseases.BMC medical informatics and decision making · 2026Trial
- Incidental Coronary Artery Calcium: Opportunistic Screening of Previous Nongated Chest Computed Tomography Scans to Improve Statin Rates (NOTIFY-1 Project).Circulation · 2023Trial
- Predictors of cholesterol treatment discussions and statin prescribing for primary cardiovascular disease prevention in community health centers.Preventive medicine · 2016 · on this mapTrial
- Trial
- Risk scoring for the primary prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2026Article
- The effectiveness of eHealth-based cardiovascular disease risk communication: a systematic review and meta-analysis.NPJ digital medicine · 2025Article
- A novel outreach approach for identification of familial hypercholesterolemia: Interview-based formative evaluation to improve healthcare access and quality.PEC innovation · 2025Article
- Primary Prevention of Cardiovascular Disease in Women.Methodist DeBakey cardiovascular journal · 2024Review
- Complications after thoracic endovascular aortic repair for ruptured thoracic aortic aneurysms remain high compared with elective repair.Journal of vascular surgery · 2022Observational
- Low-Density Lipoprotein Cholesterol Levels in Coronary Artery Disease Patients: Opportunities for Improvement.Cardiology research and practice · 2022Article
- Implementation of a multi-level community-clinical linkage intervention to improve glycemic control among south Asian patients with uncontrolled diabetes: study protocol of the DREAM initiative.BMC endocrine disorders · 2021Article
- Barriers and Facilitators to Using Statins: A Qualitative Study With Patients and Family Physicians.CJC open · 2020Article
- Developing implementation strategies to improve uptake of guideline-recommended treatments for individuals with familial hypercholesterolemia: A protocol.Research in social & administrative pharmacy : RSAP · 2020Article
- Subclinical atherosclerosis, cardiovascular health, and disease risk: is there a case for the Cardiovascular Health Index in the primary prevention population?BMC public health · 2018Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
The marked sentences are the ones the graph read a number from.
backgroundMany individuals at higher risk for cardiovascular disease (CVD) do not receive recommended treatments. Prior interventions using personalized risk information to promote prevention did not test clinic-wide effectiveness. OBJECTIVE AND
designTo perform a 9-month cluster-randomized trial, comparing a strategy of electronic health record-based identification of patients with increased CVD risk and individualized mailed outreach to usual care.
participantsPatients of participating physicians with a Framingham Risk Score of at least 5 %, low-density lipoprotein (LDL)-cholesterol level above guideline threshold for drug treatment, and not prescribed a lipid-lowering medication were included in the intention-to-treat analysis.
interventionPatients of physicians randomized to the intervention group were mailed individualized CVD risk messages that described benefits of using a statin (and controlling hypertension or quitting smoking when relevant). MAIN MEASURES: The primary outcome was occurrence of a LDL-cholesterol level, repeated in routine practice, that was at least 30 mg/dl lower than prior. A secondary outcome was lipid-lowering drug prescribing. Clinicaltrials.gov identifier: NCT01286311. KEY
resultsFourteen physicians with 218 patients were randomized to intervention, and 15 physicians with 217 patients to control. The mean patient age was 60.7 years and 77% were male. There was no difference in the primary outcome (11.0 % vs. 11.1 %, OR 0.99, 95 % CI 0.56-1.74, P = 0.96), but intervention group patients were twice as likely to receive a prescription for lipid-lowering medication (11.9 %, vs. 6.0 %, OR 2.13, 95 % CI 1.05-4.32, p = 0.038). In post hoc analysis with extended follow-up to 18 months, the primary outcome occurred more often in the intervention group (22.5 % vs. 16.1 %, OR 1.59, 95 % CI 1.05-2.41, P = 0.029).
conclusionsIn this effectiveness trial, individualized mailed CVD risk messages increased the frequency of new lipid-lowering drug prescriptions, but we observed no difference in proportions lowering LDL-cholesterol after 9 months. With longer follow-up, the intervention's effect on LDL-cholesterol levels was apparent.
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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.