Pictograms, 10-year estimates fail at communicating CVD risk

  • JAMA Cardiol

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Patients have the highest cardiovascular disease (CVD) risk awareness when clinicians communicate it using lifetime risk values, rather than 10-year CVD mortality or atherosclerotic CVD (ASCVD) risk.
  • Pictograms are less effective than bar graphs or text only.

Why this matters

  • Format, time horizon, and type of risk all affect patient buy-in.

Key results

  • When lifetime ASCVD risk was used to communicate high risk, most participants (70.1%) viewed their risk as high-very high.
  • With using 10-year ASCVD or CVD mortality, significantly fewer participants viewed their high risk accurately (31.4% and 25.7%, respectively; both P<.001 vs lifetime ascvd>
  • Most participants (77.9%) were “very willing” to go on treatment if lifetime ASCVD risk was used.
  • These values were 68.1% and 63.1% for 10-year ASCVD risk and 10-year CVD mortality, respectively (both P<.001 vs lifetime ascvd>
  • Using a pictogram was a bust; participants responded better to bar graphs or text-only information.

Study design

  • Patient and Provider Assessment of Lipid Management Registry data (n=2708; 140 US cardiology, endocrinology, primary care practices).
  • High risk: 50% lifetime ASCVD risk, 15% 10-year ASCVD risk, or 4% 10-year CVD mortality. 
  • Funding: Sanofi Pharmaceuticals, Regeneron Pharmaceuticals. 

Limitations

  • Everyone received high-risk rather than personalized score.
  • Therapy willingness evaluated using a hypothetical.

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