Patients’ Perceptions of Cholesterol, Cardiovascular Disease Risk, and Risk Communication Strategies
Ann Fam Med Goldman et al.
4: 205
Annals Journal Club Selections:
May/June 2006
The Annals Journal Club is designed to encourage a learning community of those seeking to improve health care and health through enhanced primary care. Additional information is available on the Journal Club home page.
Articles for Discussion
Frich JC, Ose L, Malterud K, Fugelli P. Perceived vulnerability to heart disease in patients with familial hypercholesterolemia: a qualitative interview study. Ann Fam Med. 2006;4:198-204.
Goldman RE, Parker D, Eaton C, et al. Patients' perceptions of cholesterol, cardiovascular disease risk, and risk communication strategies. Ann Fam Med. 2006;4:205-212.
Discussion Tips
Both journal club articles in this issue are qualitative research studies. Qualitative research involves methods that are particularly strong for discerning meaning and context from the perspective of the study group. Weaknesses of qualitative methods often relate to the degree of transparency of the analysis, the sampling of participants, and the transportability of the findings to other settings.1
Discussion Questions
Why is an understanding of patients’ risk perception important?
What are the strengths and weaknesses of the focus group study design (Goldman) versus the use of depth interviews (Frich)? How might the findings be different if the study questions were asked by surveys? What biases are apparent in the way the data were collected?
How transparent does the analysis appear for both studies? Would the results be as trustworthy if the analyses were conducted by an individual rather than a team?
How does the way the participants were selected affect your interpretation of the findings?
In qualitative research, the term “saturation” is used to indicate that a sufficient sample has been achieved such that new participants contribute relatively little new information. Do these studies’ claims of having reached saturation convince you that the important domains of information have been uncovered?
What are the main findings of each study? How do the two studies inform each other?
How transportable are the findings to other settings (particularly to yours)?
What are the studies’ implications for how clinicians should talk (or listen) to patients regarding risk and risk perception?
With the much-vaunted advent of “personalized medicine”2,3 based on genetic information, how will patients and clinicians reach a shared understanding of familial risk and personal vulnerability to heritable illness? How can the studies' findings help clinicians and patients communicate about inherited disease risk?
What do these studies say about the whole idea of (genomically) “personalized medicine” and how it might or might not be feasible and ethical in practice?
What are the implications for training clinicians and educating patients?
What are the policy implications of these findings, eg for reimbursement for primary care visits?
