A Study in Communicating Risk
By Clinical Informatics News Staff
February 6, 2014 | A suggestive recent study tried to quantify the difference between telling patients their Framingham Heart Study risk score, versus reporting their "Heart Age." Heart Age is a concept that uses the same data as the Framingham Heart Study risk score to calculate cardiovascular risk, but expresses the results in terms of how "old" a patient's heart is. A patient's heart age is equal to the age of a person with the same cardiovascular risk, but normal risk factors – the calculator can be found at www.heartage.me.
The study, made available this week in advance of publication in the European Journal of Preventive Cardiology, examined 3000 patients from the Balearic Islands in Spain, randomized into three groups: a control group who received only standard medical advice for healthy living; a group who were given their risk scores in terms of 10-year percentage risk of developing cardiovascular disease; and a group who were given their risk scores in terms of Heart Age. After one year, all members of the study underwent a followup visit and had their risk factors reexamined.
While the study looked at only a very limited timeframe and a specific patient population, its results are intriguing. Patients in the control group showed slight, but statistically significant, deterioration in several cardiovascular risk factors, including HDL cholesterol, blood pressure, and body mass index. Patients in both study groups showed improvement in each of these categories, but in every case, the Heart Age group showed the greatest improvement. Perhaps most excitingly, the greatest difference between the three groups appeared in a major behavioral risk factor: smoking. In the year between visits, the number of smokers in the control group increased slightly, while in both study groups, the number of smokers fell. However, patients in the Heart Age group were four and a half times as likely to quit smoking as those in the "percentage score" group.
Said senior author Dr. Pedro Tauler in a press statement, "This would suggest that the mere fact of presenting the patients with information that is easy to understand has a positive effect in engaging them to take preventive action. Heart Age is a cost- and time-effective strategy to motivate patients to adopt a healthier lifestyle." These findings highlight that, while data-driven metrics like the Framingham Heart Study risk score are important tools for quantifying health, when it comes to changing behavior, it's crucial to think about communication as well.
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