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Table 3 GPs’ use of different CVD risk formats

From: Communicating cardiovascular disease risk: an interview study of General Practitioners’ use of absolute risk within tailored communication strategies

  Qualitative risk formats preferred Quantitative risk formats preferred
Patient factors considered by GP - patients who don’t understand the numbers (‘blank look on face’) - bring up numbers if patient is higher risk or risk not well controlled/ managed
- numbers assumed to be less helpful for less educated/literate patients - patients who are interested in the science/evidence (males, highly educated)
- patients who will get stuck in a long discussion of the numbers rather than focusing on what they can do - use numbers to justify treatment/no treatment for borderline patients
  - withhold absolute risk from highly anxious and low risk patients - gamblers more familiar with probability
Descriptions of risk - risk level: low/negative risk, medium/moderate risk, high/severe/positive/increased risk - absolute risk % (probability of a heart attack or stroke in the next 5 or 10 years)
- multiple risk factors: coexisting, mounting up, exponential - convert absolute risk % into a frequency (e.g. 1 in 8 people like you)
- scenarios: future cardiac event, being ill for a prolonged period, explain in terms of patient’s life (e.g. family member who had CVD event) - change in absolute risk % if risk factors reduced
- analogies: compare to other risks - relative risk for particular populations (diabetics, high risk ethnicity)
   - compare individual risk factor results to guideline targets
Communication tools - position on colour-coded absolute risk chart (red = high risk, green = low risk)
- absolute risk calculator to show current/future risk and effect of risk factors
  - images (e.g. cholesterol spikes, what the brain looks like during a stroke, coronary artery to show relationship between high cholesterol and heart attack)