Self-assessment study finds need to better educate patients

A study of an Internet-based health risk assessment illustrates the need to better educate patients at risk for coronary heart disease (CHD), according to an article at the Journal of Medical Internet Research.

The research, from the Texas A&M Health Science Center and elsewhere, involved the Internet-based cardiovascular health risk assessment Heart Aware given to adult patients at 127 clinical sites. The patients generally had at least two risk factors being studied, including total cholesterol, HDL-C, LDL-C, blood pressure, body mass index and diabetes mellitus status.

It also studied agreement between self-reported and clinically measured CHD risk factors by 10-year CHD risk as established by the Framingham Heart Study, and tried to determine the effects of missing data from the self-assessments.

No risk factor had better than marginal agreement. Among the most important findings, the authors said, were that agreement for HDL-C deteriorates as 10-year CHD risk increases and rises for LDL-C as 10-year CHD risk increases. With LDL-C generally considered "bad" cholesterol and HDL-C as "good "cholesterol," people tend to think of LDL-C as the number to watch.

However, "if the evidence of HDL-C as a protective factor for CHD continues to mature, it will be vital to translate these clinical findings into actionable public health information campaigns in the community," the authors wrote.

While tools such as Heart Aware could be a cost-effective way to collect valuable CHD risk-factor data, the authors wrote, they noted that concerns about selection bias since the clinics basically steered likely candidates to the assessment--and those who took it most likely were more Internet-savvy.

Social media and online communities address many of the preventable problems that lead to chronic disease by promoting healthy eating, active living and wellness, a recent eHealth Initiative report found.

And while an array of new devices provide more ways for chronic heart failure patients to manage their condition, a small study found privacy concerns, mistrust of online data and low computer literacy among patients. They still looked to their doctors as their leading source of information.

To learn more:
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