PURPOSE This study aimed to determine which methods of expressing a preventive medication's benefi t encourage patients with known cardiovascular disease to decide to take the medication and which methods patients prefer. METHODSWe identifi ed patients in Auckland, New Zealand, family practices located in areas of differing socioeconomic status who had preexisting heart disease (myocardial infarction, angina, or both) and were taking statins. The patients were interviewed about their preference for methods of expressing the benefi t of a hypothetical medication. Benefi ts were expressed numerically (relative risk, absolute risk, number needed to treat, odds ratio, natural frequency) and graphically. Statistical testing was adjusted for practice. RESULTSWe interviewed 100 eligible patients, representing a 53% response rate. No matter how the risk was expressed, the majority of patients indicated they would be encouraged to take the medication. Two-thirds (68) of the patients preferred 1 method of expressing benefi t over others. Of this group, 57% preferred the information presented graphically. This value was signifi cantly greater (P <.001) than the 19% who chose the next most preferred option, relative risk. Few patients preferred absolute risk (13%) or natural frequencies (9%). Only a single patient (1%) preferred the odds ratio. None preferred number needed to treat. Ninety percent of patients responding to a question about framing preferred positive framing (description of the benefi t of treatment) over negative framing (description of the harm of not being treated).CONCLUSIONS Although number needed to treat is a useful tool for communicating risk and benefi t to clinicians, this format was the least likely to encourage patients to take medication. As graphical representation of benefi t was the method patients preferred most, consideration should be given to developing visual aids to support shared clinical decision making.

Background/Objectives: The Vulval diseaseQuality of Life Index (VQLI) is a new tool that assesses the burden of vulval disease on quality of life (QoL). Our objective was to assess the correlation between VQLI score and clinician-rated severity scores, overall patient itch/discomfort, disease duration, sexual activity, and age, in vulval lichen sclerosus (VLS) at a vulval disorders clinic.Methods: A retrospective case note review, including consecutive women with VLS who attended the clinic between April and October 2018. Outcome measures include the VQLI score, clinician-rated severity score, and patient symptom score.Results: A total of 109 women with VLS were included. On multivariable analysis, there was evidence of a positive relationship between VQLI scores and the total clinician-rated score (mean increase in VQLI score per unit increase in clinician score 1.34, 95% confidence interval [CI] 0.31, 2.38; P = 0.01); the relationship was stronger for the cutaneous component. There was little evidence for relationships of the VQLI with the patient's age, sexual activity or time since onset of symptoms. There was strong evidence for a positive relationship between VQLI score and overall itch/discomfort score (mean increase 2.38, 95% CI 1.88, 2.88; P < 0.001). New and followup data were obtained on sequential visits for 12 women, among whom the VQLI score dropped a mean À2.75 points between visits (95% CI À6.05, 0.55; P = 0.094). Conclusion:The clinician-rated severity correlates with the impact of VLS on QoL. The VQLI captures information included in a patient itch/discomfort score, which can be easily incorporated into routine assessment.