Atherosclerosis Screening by Noninvasive Imaging for Cardiovascular Prevention: A Systematic Review

Can Communicating Personalised Disease Risk Promote Healthy Behaviour Change? A Systematic Review of Systematic Reviews

“…Language restrictions unclear, forward citation searching, grey literature included, search strategy provided 4 trials (2 ultrasound, 2 computed tomography feedback) 684 Marteau (2010) [ 19 ] Communicating DNA-based risk estimates Health-related behaviours (smoking [ n =5], diet [=2], physical activity [ n =2]) 5 sources searched (April 2010): Cochrane, MEDLINE, EMBASE, CINAHL, PsycINFO. No language restrictions, forward citation searching, grey literature included, search strategy provided 7 trials: 6 genetic testing only; 1 genetic testing + carbon monoxide testing 2762 Author (date) Intervention Outcome and participants Search strategy Number of studies included Total N Rodondi (2011) [ 26 ] Feedback of noninvasive atherosclerosis screening Health-related behaviours (smoking [ n =7], diet [=6], physical activity [ n =5]) to reduce risk in people without pre-existing CVD 2 sources searched (September 2009): Cochrane and MEDLINE. All languages, backward citation searching, no grey literature included, no search terms provided 9 trials (3 RCTs, 6 non-RCTs) – 6 computed tomography, 2 carotid ultrasound, 1 total body scan 3340 ( n =659 from RCTs, n = 2681 from non-RCTs) Sheridan (2010) [ 22 ] Providing CHD risk estimation (including counselling/ education) Health-related behaviours (smoking [ n =6], diet [=3], physical activity [ n =5]) for primary prevention in people without CHD 4 databases searched (Cochrane, PsycINFO, CINAHL, Medline) in Dec 2008.…”

“…Specifically, the majority of the reviews indicated that there was little, limited or no evidence of effects on the behaviours studied [ 17 , 19 , 22 – 24 ]. Other reviews did not comment on the effects on behaviour [ 22 ], indicated that there may be effects in the short-term but not long-term [ 25 ], that results were “mixed” [ 26 ] or that personalised risk information may be effective, but should be judged on an individual basis and not assumed as a general principle [ 27 ].…”

“…For physical activity analysis, I 2 = 0% Sensitivity analysis excluding one study that had incomplete reporting of missing data had little effects on overall smoking results. “Claims that receiving DNA-based test results motivate people to change their behaviour are not supported by evidence.” “Weak evidence based on a small number of studies of limited quality.” Rodondi (2011) [ 26 ] No statistical aggregation of findings due to heterogeneity Feedback on smoking – 1 significant, 6 non-significant Feedback on diet – 4 significant, 2 non-significant Feedback on physical activity – 1 significant, 4 non-significant Study quality assessed by design, methods of randomization and reporting of losses to follow-up – not blinding. Data not statistically aggregated “Available evidence limited, with mixed results on cardiovascular risk factor control” Sheridan (2010) [ 22 ] No statistical aggregation of findings Risk estimates on varied smoking outcomes – 2 significant, 4 non-significant Risk estimates on diet – “mixed results” Risk estimates on physical activity – “mixed results” 2 trials judged to be good quality, 5 judged to be fair quality Data not statistically aggregated.…”

“…The most promising method of communicating risk information appears to be those that employed imaging or visual techniques such as tomography or ultrasound, which were considered by three reviews [ 26 – 28 ]. In one review [ 27 ], the three trials that reported effects of visual imaging on smoking cessation were overall statistically significant (OR=2.81, 95%CI 1.23 to 6.41).…”

Acute effects of vinegar intake on some biochemical risk factors of atherosclerosis in hypercholesterolemic rabbits

“…Interestingly, chronically expanding lesions are often asymptomatic until the artery stenosis is so severe that the blood supply to downstream tissue (s) is insufficient and results in ischemia. [3]…”