A survey of physicians show a one-third reduction in harmful outcomes to be a clinically important difference for statin therapy
Journal of Clinical Epidemiology, 07/05/2012
Li KK et al. – Physicians were consistent in their choice of minimal clinically important difference (MCID) for statin therapy across vascular events. They required a larger benefit of statin therapy for patients at a lower baseline risk (5%) of developing a vascular event before they would recommend treatment.Methods
- A self–administered questionnaire was sent to family practitioners, internal medicine specialists, and cardiologists practicing in Hamilton.
- They provided an MCID of statin therapy using clinical scenarios based on 5–year risk of vascular outcomes, namely coronary death, nonfatal myocardial infarction, stroke, and coronary revascularization.
- Two hundred nine physicians participated, of which 638 were initially approached.
- Physicians would recommend statin therapy if it would at least reduce the relative risk of vascular events by about one–third.
- For patient scenarios involving a 30%, 13%, and 5% baseline risk of developing a vascular event in 5 years, physicians would recommend treatment if it would reduce the baseline risk by 31.4% (standard deviation [SD], 19.8), 34.6% (SD, 18.0), and 46.2% (SD, 24.6), respectively.