Table 1

Characteristics of included systematic reviews

Systematic review ID
Brindle 200631Sheridan 200832Sheridan 201033Waldron 201134van Dieren 201235Usher-Smith 201536
Review objective(s)‘To determine the accuracy of assessing CVD risk in the primary prevention of CVD and its impact on clinical outcomes’‘To assess whether global CHD risk scores result in clinical benefits or harms’‘To assess the effect of providing global CHD risk information to adults’‘To compare different interventions used to communicate cardiovascular risk and assess their impact on patient related outcomes’‘To review the primary prevention studies that focused on the development, validation and impact assessment of a cardiovascular risk model, scores or rules’‘To systematically review whether the provision of information on cardiovascular disease (CVD) risk to healthcare professionals and patients impacts their decision-making, behaviour and ultimately patient health.’
PopulationPeople ‘predominantly free from symptomatic CVD’‘Adults (>18) with no prior history of CVD’‘Adults with no history of CVD’Adults (>18)‘People with type 2 diabetes’People ‘with no history of CVD’
Intervention(s)‘Healthcare professional using a CVD risk score to aid primary prevention’‘Physician knowledge of a global CHD risk score’‘Global CHD risk presentation as the primary intervention or part of a multipart intervention’‘Communication interventions (of any format) for individualised CVD assessment’‘CVD predictions models that have been developed… or validated in a diabetes population’‘Intervention strategy consisted of provision of a CVD risk model estimate to either physicians or patients’
Comparison(s)Usual care‘Either simple risk factor counting or no formal assessment of risk’Not prespecifiedControl or usual care armNot prespecifiedNo ‘provision of a CVD risk model estimate’
Country of primary
review author		UKUnited States of AmericaUnited States of AmericaUKThe NetherlandsUK
AMSTAR4/114/117/115/110/115/11
Eligible study designsRCTsAny designAny design‘Any quantitative design’Not specifiedRandomised and non-randomised primary studies
Databases searchedCENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, ZETOC,
ISI Proceedings		MEDLINEMEDLINE, PsycINFO, CINAHL, Cochrane DatabaseASSIA, CINAHL, EMBASE, MEDLINE, PsycINFO, Science Citation Index expandedMEDLINEMEDLINE, PubMed
Date of database search200420072008200820112013
Meta-analysis?NoNoNoNoNoYes
Review method of quality assessmentNo formal assessment. ‘Information on the methodological quality of the trials including the method of randomisation, concealment of allocation, baseline group comparisons and blind outcome assessment was collected’Criteria adapted from the US Preventive Services Task ForceCriteria adapted from the US Preventive Services Task ForceDowns and Black checklistQuality not assessedFollowed critical appraisal skills programme guidelines
Review authors' conclusions‘Evidence supporting the use of cardiovascular risk scores for primary prevention is scarce’‘We found surprisingly little evidence that physician knowledge of global CHD risk currently translates into improved clinical outcomes’‘Global CHD risk information seems to improve the accuracy of risk perception and may increase intent to initiate CHD prevention among individuals at moderate to high risk. The effect of global risk presentation on more distal outcomes is less clear and seems to be related to the intensity of accompanying interventions.’‘Better quality trials are needed that compare different risk presentation formats before conclusions can be drawn’‘The impact of applying these risk scores in clinical practice is almost completely unknown, but their use is recommended in various national guidelines.’‘There seems evidence that providing CVD risk model estimates to professionals and patients improves perceived CVD risk and medical prescribing, with little evidence of harm on psychological well- being.’

  • CHD, coronary heart disease.