Effects of an evidence-based computerized virtual clinician on low-density lipoprotein and non-high-density lipoprotein cholesterol in adults without cardiovascular disease: The Interactive Cholesterol Advisory Tool

Abstract

There is a lack of research on the use of electronic tools that guide patients toward reducing their cardiovascular disease risk. We conducted a 9-month clinical trial in which participants who were at low (n = 100) and moderate (n = 23) cardiovascular disease risk-based on the National Cholesterol Education Program III's 10-year risk estimator-were randomized to usual care or to usual care plus use of an Interactive Cholesterol Advisory Tool during the first 8 weeks of the study. In the moderate-risk category, an interaction between treatment condition and Framingham risk estimate on low-density lipoprotein and non-high-density lipoprotein cholesterol was observed, such that participants in the virtual clinician treatment condition had a larger reduction in low-density lipoprotein and non-high-density lipoprotein cholesterol as their Framingham risk estimate increased. Perceptions of the Interactive Cholesterol Advisory Tool were positive. Evidence-based information about cardiovascular disease risk and its management was accessible to participants without major technical challenges.

Trial registration: ClinicalTrials.gov NCT01890031.

Keywords: cardiovascular disease; cardiovascular disease risk; low-density lipoprotein cholesterol; non-high-density lipoprotein cholesterol; virtual clinician.

Conflict of interest statement

Declaration of Conflicting Interest: Geoffrey C. Williams and C. Scott Rigby are shareholders in Self-Determined Health, Inc., the company to which the SBIR grant was awarded. Drs. Williams and Rigby were involved in the development of the virtual clinician and contributed only to the introduction and methods sections of this report. Dr. Williams managed subjects in both of the moderate risk groups, and those subjects were informed (via the study consent form) of Dr. Williams’ interest in the company. Drs. Williams and Rigby did not have access to the data or contribute to the interpretation of the results.

© The Author(s) 2015.

Figures

Figure 1

Study Timeline *Only participants in the moderate risk and extra low risk categories were asked to attend these visits. The darker-shaded regions represent the protocol-specified time periods in which each task was designed to be completed, although not all tasks were completed within these time periods.