Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Sep 16;19(18):11705.
doi: 10.3390/ijerph191811705.

Decision Support Tools for Coronary Artery Calcium Scoring in the Primary Prevention of Cardiovascular Disease Do Not Meet Health Literacy Needs: A Systematic Environmental Scan and Evaluation

Shannon McKinn  1 , Carys Batcup  1 , Samuel Cornell  1 , Natasha Freeman  1 , Jenny Doust  2 , Katy J L Bell  1 , Gemma A Figtree  3 , Carissa Bonner  1
Affiliations
Review

Decision Support Tools for Coronary Artery Calcium Scoring in the Primary Prevention of Cardiovascular Disease Do Not Meet Health Literacy Needs: A Systematic Environmental Scan and Evaluation

Shannon McKinn et al. Int J Environ Res Public Health. .

Abstract

A shared decision-making approach is considered optimal in primary cardiovascular disease (CVD) prevention. Evidence-based patient decision aids can facilitate this but do not always meet patients' health literacy needs. Coronary artery calcium (CAC) scans are increasingly used in addition to traditional cardiovascular risk scores, but the availability of high-quality decision aids to support shared decision-making is unknown. We used an environmental scan methodology to review decision support for CAC scans and assess their suitability for patients with varying health literacy. We systematically searched for freely available web-based decision support tools that included information about CAC scans for primary CVD prevention and were aimed at the public. Eligible materials were independently evaluated using validated tools to assess qualification as a decision aid, understandability, actionability, and readability. We identified 13 eligible materials. Of those, only one qualified as a decision aid, and one item presented quantitative information about the potential harms of CAC scans. None presented quantitative information about both benefits and harms of CAC scans. Mean understandability was 68%, and actionability was 48%. Mean readability (12.8) was much higher than the recommended grade 8 level. Terms used for CAC scans were highly variable. Current materials available to people considering a CAC scan do not meet the criteria to enable informed decision-making, nor do they meet the health literacy needs of the general population. Clinical guidelines, including CAC scans for primary prevention, must be supported by best practice decision aids to support decision-making.

Keywords: cardiovascular diseases; decision making; health literacy; patient education; primary prevention; shared.

PubMed Disclaimer

Conflict of interest statement

The authors have no relevant disclosures to make with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Study search strategy and results.
See this image and copyright information in PMC

References

    1. Chua A., Blankstein R., Ko B. Coronary artery calcium in primary prevention. Aust. J. Gen. Pract. 2020;49:464–469. doi: 10.31128/AJGP-03-20-5277. - DOI - PubMed
    1. Lloyd-Jones D.M., Braun L.T., Ndumele C.E., Smith S.C., Sperling L.S., Virani S.S., Blumenthal R.S. Use of risk assessment tools to guide decision-making in the primary prevention of atherosclerotic cardiovascular disease: A special report from the American Heart Association and American College of Cardiology. Circulation. 2019;139:e1162–e1177. doi: 10.1161/CIR.0000000000000638. - DOI - PubMed
    1. Mach F., Baigent C., Catapano A.L., Koskinas K.C., Casula M., Badimon L., Chapman M.J., De Backer G.G., Delgado V., Ference B.A., et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Eur. Heart J. 2020;41:111–188. doi: 10.1093/eurheartj/ehz455. - DOI - PubMed
    1. US Preventive Services Task Force Risk assessment for cardiovascular disease with nontraditional risk factors: US Preventive Services Task Force recommendation statement. JAMA. 2018;320:272–280. doi: 10.1001/jama.2018.8359. - DOI - PubMed
    1. Arnett D.K., Blumenthal R.S., Albert M.A. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J. Am. Coll. Cardiol. 2019;74:e177–e232. doi: 10.1016/j.jacc.2019.03.010. - DOI - PMC - PubMed

Publication types

MeSH terms