Communicating risk in primary care: what the Academy of Medical Sciences' report means in practice.

Abstract

In 2014, the National Institute for Health Care Excellence (NICE) changed its guidelines for offering statins to patients, reducing the threshold from 20% cardiovascular risk to 10%.1 This ignited a fervent debate about the wisdom and practicality of the change and raised three key questions: Do we really have the right evidence on which to make a decision about the risk/benefit balance? Is that evidence trustworthy when applied to patients seen in general practice? How can we communicate the best possible evidence to the people who need to make the relevant decisions: policy makers, clinicians, and the public? These questions are not, of course, specific to the issue of statins; they go to the heart of how healthcare decisions are made and as a result were the trigger for a request from the Chief Medical Officer of England to the Academy of Medical Sciences (AMS) to examine the issues in detail. The resulting report was finally published last month.2 The report presents 12 recommendations (Box 1) that are planned to address nothing less than the scientific basis of medicine: from deciding how research efforts should be targeted, to guidelines for science reporting in the media; from improving the methodology of clinical trials to the design of patient information leaflets. But what does it mean for GPs? Box 1: ### The 12 recommendations Ensuring evidence is robust and relevant: