SynthesisJournal of medical Internet research2018
Clinical Validity, Understandability, and Actionability of Online Cardiovascular Disease Risk Calculators: Systematic Review.
Synthesis in Journal of medical Internet research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 4 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
39 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Evaluating Readability, Understandability, and Actionability of Online Printable Patient Education Materials for Cholesterol Management: A Systematic Review.Journal of the American Heart Association · 2024Pooled it
- Cardiovascular disease risk communication and prevention: a meta-analysis.European heart journal · 2024Pooled it
- Availability and readability of patient education materials for deprescribing: An environmental scan.British journal of clinical pharmacology · 2019Pooled it
- Pooled it
- Effect of interdisciplinary obesity care on metabolic markers and body weight in people with type 2 diabetes in a rural setting: A randomised controlled trial.Clinical obesity · 2025Trial
- Discordance Between Textual Reasoning and Visual Interpretation in Large Language Models for Low Back Pain: Cross-Sectional Quantitative Evaluation and Exploratory Multimodal Stress Test.JMIR medical informatics · 2026Article
- Evaluating the quality of online patient education materials for gastric adenocarcinoma.Frontiers in digital health · 2026Article
- Optimizing Cardiovascular Risk Management in Primary Care Using a Personalized eCoach Solution Enhanced by an Artificial Intelligence-Driven Clinical Prediction Model: Protocol from the Coronary Artery Disease Risk Estimation and Early Detection Consortium.JMIR research protocols · 2025Article
- Appropriateness of Web-Based Resources for Home Blood Pressure Measurement and Their Alignment With Guideline Recommendations, Readability, and End User Involvement: Environmental Scan of Web-Based Resources.JMIR infodemiology · 2025Article
- Comparing predictive risk to actual presence of coronary atherosclerosis on coronary computed tomography angiography.American heart journal plus : cardiology research and practice · 2025Article
- Usefulness of Atherogenic Indices for Predicting High Values of Avoidable Lost Life Years Heart Age in 139,634 Spanish Workers.Diagnostics (Basel, Switzerland) · 2024Article
- Comparing a Digital Health Check With Traditional Nurse-Led Health Examinations Among Long-Term Unemployed Individuals: Comparison Study.Journal of medical Internet research · 2024Article
- Medical calculators derived synthetic cohorts: a novel method for generating synthetic patient data.Scientific reports · 2024Article
- Exploring Web-Based Information and Resources That Support Adolescents and Young Adults With Cancer to Resume Study and Work: Environmental Scan Study.JMIR cancer · 2024Article
- Guideline-Based Cardiovascular Risk Assessment Delivered by an mHealth App: Development Study.JMIR cardio · 2023Article
- Implementing patient decision aids into general practice clinical decision support systems: Feasibility study in cardiovascular disease prevention.PEC innovation · 2023Article
- Selfie-Related Incidents: Narrative Review and Media Content Analysis.Journal of medical Internet research · 2023Review
- The Impact and Perception of England's Web-Based Heart Age Test of Cardiovascular Disease Risk: Mixed Methods Study.JMIR cardio · 2023Article
- Biological age calculators to motivate lifestyle change: Environmental scan of online tools and evaluation of behaviour change techniques.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2023Article
- Assessment of Understandability and Actionability of YouTube Videos on Hemolytic Disease of the Newborn.Cureus · 2023Article
Corrections and comments
- Commented on by
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOnline health information is particularly important for cardiovascular disease (CVD) prevention, where lifestyle changes are recommended until risk becomes high enough to warrant pharmacological intervention. Online information is abundant, but the quality is often poor and many people do not have adequate health literacy to access, understand, and use it effectively.
objectiveThis project aimed to review and evaluate the suitability of online CVD risk calculators for use by low health literate consumers in terms of clinical validity, understandability, and actionability.
methodsThis systematic review of public websites from August to November 2016 used evaluation of clinical validity based on a high-risk patient profile and assessment of understandability and actionability using Patient Education Material Evaluation Tool for Print Materials.
resultsA total of 67 unique webpages and 73 unique CVD risk calculators were identified. The same high-risk patient profile produced widely variable CVD risk estimates, ranging from as little as 3% to as high as a 43% risk of a CVD event over the next 10 years. One-quarter (25%) of risk calculators did not specify what model these estimates were based on. The most common clinical model was Framingham (44%), and most calculators (77%) provided a 10-year CVD risk estimate. The calculators scored moderately on understandability (mean score 64%) and poorly on actionability (mean score 19%). The absolute percentage risk was stated in most (but not all) calculators (79%), and only 18% included graphical formats consistent with recommended risk communication guidelines.
conclusionsThere is a plethora of online CVD risk calculators available, but they are not readily understandable and their actionability is poor. Entering the same clinical information produces widely varying results with little explanation. Developers need to address actionability as well as clinical validity and understandability to improve usefulness to consumers with low health literacy.
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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.