Nadeem Qureshi, DM; Paula Dhiman, MSc; Joe Kai, MD
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1217.
Qureshi N., Dhiman P., Kai J.; Adding Systematic Family History Enquiry to Cardiovascular Disease Risk Assessment: Clinical Utility in Primary Care. Ann Intern Med. 2012;157:149. doi: 10.7326/0003-4819-157-2-201207170-00020
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Published: Ann Intern Med. 2012;157(2):149.
We agree with Dr. Goff that further study of the discriminatory accuracy of positive and negative family history in cardiovascular disease risk assessment algorithms is needed.
The comments from Dr. Robson and colleagues and other trials (1) provide relevant information. However, our research had a clinical rather than an epidemiologic aim and thus addressed different questions. We were concerned with clinical utility. We assessed the feasibility and impact of systematically collecting family history in comparison with its usual ad hoc collection and subsequent use in cardiovascular risk assessment in family practice (2). Our study offers the highest level of evidence for this sort of clinical intervention by use of a cluster randomized trial.
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