James McCormack discusses the Scottish Cardiovascular DES

About this episode

Professor James McCormack discusses the Scottish Cardiovascular DES and advocates for a patient-centered approach to treatment decisions.

In this episode, we discuss the Scottish Cardiovascular DES designed to reduce adverse cardiovascular events by tackling population-wide risk factors like high blood pressure, raised glucose and cholesterol. Professor James McCormack suggests a greater focus on shared decision making with patients, arguing that the common 10% risk threshold used to trigger treatment is an arbitrary figure that often fails to clearly define what the risk actually entails. He contends that most guidelines can overlook the individual. With years of experience of teaching how to explain and apply evidence, using humour, he advocates for a foundational shift toward a patient-centred model, where treatment decisions are made with patients, not for them. The conversation explores how to put this philosophy into practice. Risk calculators such as ASSIGN and QRISK should not be used as diagnostic dictators, but as educational tools to start a conversation. He is highly critical of using terms like "pre-diabetes" or "high risk," which can cause patients to vastly overestimate their danger and create unnecessary anxiety. The solution is clear communication: using visual aids and explaining absolute benefits…

People in this episode

Guest: James McCormack

Topics covered

• cardiovascular health
• shared decision making
• patient-centered care
• risk assessment

Keywords

• high blood pressure
• cholesterol
• pre-diabetes
• risk calculators
• ASSIGN
• QRISK

Mentioned in this episode

Products: the Scottish Cardiovascular DES, ASSIGN, QRISK, ASSIGN v2, statin

Books & works: Contented Clinician, The Surrogate Battle

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