Diagnosis or Risk Factors to Guide Statin Use?

Article for Discussion

Johansen ME, Green LA, Sen A, Kircher S, Richardson CR. Cardiovascular risk and statin use in the United States. Ann Fam Med. 2014;12 (3):215–223.

Discussion Tips

This study provides a chance to consider factors associated with taking statin drugs in a nationally-representative sample of patients, and to consider the implications for our own prescribing practices.

Discussion Questions

• What question is asked by this study and why does it matter?

• How does this study advance beyond previous research and clinical practice on this topic?

• How strong is the study design for answering the question?

• To what degree can the findings be accounted for by:

  • How patients were selected, excluded, or lost to follow-up? (How representative is this nationally-representative survey?)

  • How the main variables were measured?

  • Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a 3rd factor)?

  • Chance?

  • How the findings were interpreted?

• What are the main study findings?

• How comparable is the study sample to similar patients in your practice? What is your judgment about the transportability of the findings?

• What contextual factors are important for interpreting the findings?^2–5

• How might this study change your practice? Policy? Education? Research?

• Who the constituencies are for the findings, and how they might be engaged in interpreting or using the findings?

• What are the next steps in interpreting or applying the findings?

• What researchable questions remain?