All analyses were performed in JMP Pro, version 10.0.0 (SAS Institute Inc). A comparison between the groups was performed using an unpaired t test. A paired difference test was used to assess changes over time within each group. We tested the association of GRS with family history, using t tests with significance set at P < .05. We compared the rate of statin initiation between participants with and those without a family history of CHD using logistic regression, also adjusting for allocation to GRS. 8 Continuous or dichotomous variables were compared between groups using a 2-sample t test or a χ 2 test, respectively. Participants returned at 3 and 6 months after risk disclosure for measurement of low-density lipoprotein cholesterol levels and assessment of statin use, dietary fat consumption (scores ranged between 0 to 110 indicative of very high dietary fat intake as measured by the fat screener 7), and physical activity levels (scores ranged between 7 and 1 based on the adapted version of telephonic assessment of a physical activity questionnaire). All participants gave written informed consent financial compensation was provided. The study protocol was approved by the Mayo Clinic institutional review board. 6 The 10-year risk of CHD was disclosed by a genetic counselor informing participants of a 1.5- to 2.0-fold higher risk in the presence of family history, followed by shared decision making regarding statin therapy with a physician. A GRS was calculated based on genotypes at 28 CHD susceptibility loci. Family history was defined as the presence of CHD (ie, angina, myocardial infarction, or myocardial revascularization) in a first-degree male or female relative (ie, parents, siblings, and children) before age 55 or 65 years, respectively. Shared Decision Making and Communicationīetween October 9, 2013, and April 28, 2014, residents of Olmsted County, Minnesota, at intermediate risk for CHD and not receiving statin therapy were randomized 1:1 to either a conventional (Framingham) risk score (FRS) 5 alone or FRS supplemented with a GRS.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.
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Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.