Related Experiment Videos
Can computerized risk profiles help patients improve their coronary risk? The results of the Coronary Health
I Lowensteyn1, L Joseph, C Levinton
1Centre for the Analysis of Cost-Effective Care and the Divisions of General Internal Medicine and Clinical Epidemiology, The Montreal General Hospital, Quebec, Vanada, H3G 1A4.
Insights
Computerized coronary risk profiles effectively help doctors identify high-risk patients for cardiovascular disease prevention. This tool significantly improves patient lipid profiles and reduces overall coronary risk.
Area of Science:
- Cardiology
- Preventive Medicine
- Health Informatics
Background:
- The Coronary Health Assessment Study (CHAS) investigated the use of computerized coronary risk profiles.
- This aimed to assess their feasibility as a clinical decision aid for primary prevention of Coronary Heart Disease (CHD).
Purpose of the Study:
- To determine if patient-specific, multifactorial computerized coronary risk profiles aid in primary prevention of CHD.
- To evaluate the effectiveness of these profiles as a clinical decision support tool for physicians.
Main Methods:
- 253 physicians and 958 patients were randomized into profile and control groups.
- Physicians in the profile group received patient risk profiles within 10 days for early feedback.
- Patients' coronary risk factors were assessed at baseline and follow-up.
Main Results:
- The profile group showed a significantly higher ratio of high-risk to low-risk patients returning for follow-up.
- Patients receiving profiles had greater reductions in total cholesterol, LDL cholesterol, and total cholesterol/HDL ratio.
- Significant reductions in predicted 8-year coronary risk were observed in the profile group.
Conclusions:
- Computer-generated coronary risk profiles effectively assist physicians in identifying high-risk individuals.
- Utilizing these profiles leads to significant improvements in patient serum lipid profiles and overall coronary risk.
Background:
The Coronary Health Assessment Study (CHAS) was developed to determine the feasibility of using patient-specific, multifactorial computerized coronary risk profiles as a clinical decision aid to support primary prevention of CHD.
Methods:
Study participants included 253 community based physicians, randomized into profile and control groups, and 958 of their patients. The profile group physicians received coronary risk profiles for their patients within 10 working days after the baseline patient assessment providing early feedback. The control group received their profiles only if the patient was clinically reevaluated during a 3-month follow-up visit. Patients' coronary risk factors were evaluated at baseline and at follow-up.
Results:
The profile group had a significantly higher (P < 0.05) ratio of high-risk/low-risk patients who returned for a follow-up visit compared to the control group (1.23 vs 0.77). The patients in the profile group also had significantly (P < 0.05) greater mean reductions in total cholesterol (-0.5 vs -0.1 mmol/L), LDL cholesterol (-0.4 vs 0.0 mmol/L), the total cholesterol/ HDL ratio (-0.6 vs -0.2), and the predicted 8-year coronary risk (-1.8 vs -0.3%).
Conclusions:
Computer-generated coronary risk profiles can be effective in assisting physicians to identify high-risk patients. Their use is also associated with significantly greater improvements in the serum lipid profiles and the overall coronary risk of these patients.