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Editor's Correspondence |

Informing Patients of Their Coronary Risk

Afschin Gandjour, MD, PhD
Arch Intern Med. 2008;168(15):1719. doi:10.1001/archinte.168.15.1719-a.
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Grover and colleagues1 present a randomized controlled trial in which physicians inform patients with dyslipidemia of their coronary risk. The trial shows that informing patients improves the risk profile over 12 months. However, it is not clear why we actually need this study. Hardly any physician would argue that sharing information on coronary risk is something invaluable in patients without cognitive impairment. Therefore, there seem to be other reasons why this has not become common practice. It is likely that physicians lack time, and it is far from clear that merely providing them with the result of this trial changes their practice.2 Given that physicians could well spend almost their entire workday with preventive and counseling activities,3 tradeoffs between alternative ways to improve coronary risk become important; is it more valuable to provide information on coronary risk or give detailed advice on exercising? Even if the study by Grover and colleagues1 had not shown a significant effect, would we have really recommended not sharing information? This seems questionable because each setting is unique and depends on the physician's communication skills and the patient's receptiveness.

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