Presenting the improved possibility for staying well might be better than talking about change in risk: Use of the Non-Occurrence Probability Increase (NOPI)

Figures & data

Table I. General practitioners’ perception of the difference between risk and chance.

	Treatment effect presented as relative risk reduction (RRR)	Treatment effect presented as non-occurrence probability increase (NOPI)	P-value (chi-squared with Yates's correction)
Example 1: You are a 55-year-old woman. Drugs may affect probability of future cardiovascular death^a	Would you reduce your risk for a cardiovascular death during a 10-year period by 50% with medication? 68% (90/132) of GPs said yes	Would you increase your chance of avoiding a cardiovascular death during a 10-year period from 98% to 99% with medication? 18% (25/136) of GPs said yes	< 0.001
Example 2: You are a 60-year-old man and have at least two risk factors – smoking, stroke, transient ischaemic attack (TIA), or hereditary – for cardiovascular disease Drugs may affect the probability of a future cardiovascular event?^b	Would you reduce your risk for a cardiovascular event during a 3–4 year period by 33% with medication? 86% (55/64) of GPs said yes	Would you increase your chance of avoiding a cardiovascular event during a 3–4 year period from 97% to 98% with medication? 16% (10/62) of GPs said yes	< 0.001

Notes: ^aWilhelmsen et al. [7]. ^bSever et al. [8].

Wilhelmsen L, Wedel H, Conroy R, Fitzgerald T. The Swedish SCORE chart for cardiovascular risk: Better possibilities for prevention of cardiovascular diseases. Lakartidningen 2004;101:1798–801 (in Swedish).

 PubMedGoogle Scholar

Sever PS, Dahlöf B, Poulter NR, Wedel H, Beevers G, Caulfield M, et al. ASCOT Investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA): A multicentre randomised controlled trial. Drugs 2004; 64(Suppl 2):43–60.

 PubMedGoogle Scholar