Table 1.
Studies included in the review
| Authors | Population | Perceived risks | Comparator | Outcomes |
|---|---|---|---|---|
| A. Studies investigating absolute accuracy | ||||
| Allen et al. (2010) 15 | (a) n = 143. (b) Urban, low SES, middle‐aged Black women. (c) No CVD. (d) At least one additional CV risk factor | Own absolute lifetime risk of CVD (numerical) | Based on physiological measures | Overestimation |
| Asimakopoulou et al. (2008) 16 | (a) n = 95. (b) No CVD | Own absolute lifetime risk of CHD (numerical) | UKPDS‐OM risk estimate | Overestimation (factor 3.5) |
| Own absolute lifetime risk of stroke (numerical) | UKPDS‐OM risk estimate | Overestimation (factor 5.5) | ||
| Frijling et al. (2004) 20 | (a) n = 450. (b) No atherosclerotic disease | Own absolute 10‐year risk of MI (numerical) | Framingham risk score | Overestimation (factor 4) |
| Own absolute 10‐year risk of stroke (numerical) | Framingham risk score | Overestimation (factor 4.7) | ||
| Hoffmann and Del Mar (2012) 21 | n = 91 | Average absolute 15‐year risk of diabetes‐related eye complication (numerical) | Klein et al. 33 | Underestimation (factor 2.3) |
| Martell‐Claros et al. (2011) 25 | (a) n = 511. (b) Diagnosed for < 1 year. (c) No history of CV event or disease. (d) No insulin therapy | Own absolute lifetime risk of CVD (verbal) | Based on physiological measures (ESH‐ESC 2007 guidelines) | No agreement between perceived and calculated risks |
| Portnoy et al. (2014) 28 | (a) n = 83. (b) Diagnosed for at least 1 year. (c) No history of CV event or CHD | Own absolute 10‐year/lifetime risk of developing/dying from CHD (numerical) | UKPDS‐OM risk estimate | No agreement between perceived and calculated risks |
| Welschen et al. (2012) 32 | (a) n = 204. (b) No history of CVA or TIA | Own absolute 10‐year risk of CVD, after being told estimates for average diabetic men and women (numerical) | UKPDS‐OM risk estimate | No agreement between perceived and calculated risks |
| B. Studies investigating optimistic bias | ||||
| Choi et al. (2008) 19 | (a) n = 143. (b) Diagnosed for at least 1 year. (c) Korean immigrants | Own risk perception score for CHD (optimistic bias section of the B&L index, verbal) | Perceived risk attributed to people of similar age and sex in the general population | Underestimation (optimistic bias) |
| Homko et al. (2010) 22 | (a) n = 211. (b) No history of CVD. (c) At least 10% 10‐year risk of CVD (Framingham risk score). (d) No ESRD or dialysis. (e) No participants from nursing or boarding home | Own comparative 10‐year risk of CHD, high BP and stroke (S&R risk score, verbal) | Perceived risk attributed to peers without diabetes | Higher risk perception among women. No agreement between perceived risks and actual risks (Framingham risk score) |
| Portnoy et al. (2014) 28 | (a) n = 83. (b) Diagnosed for at least 1 year. (c) No history of CV event or CHD | Own comparative 10‐year/lifetime risk of developing/dying from CHD (numerical) | Perceived risk attributed to the average person | Slight overestimation (pessimism) |
| Walker et al. (2007) 31 | (a) n = 250. (b) Socially deprived. (c) No dilated eye examination undergone over the past year | Own comparative risk perception (optimistic bias section of the RPS‐DM, verbal) | Perceived risk attributed to diabetic peers | Higher optimistic bias in people born abroad and with lower education |
| C. Studies assessing a risk perception score | ||||
| Calvin et al. (2011) 17 | (a) n = 143. (b) Diagnosed for < 5 years. (c) Urban African Americans. (d) No known complication | Own risk perception score for complications (RPS‐DM) | Based on physiological measures | Low perception of risks |
| Choi et al. (2008) 19 | (a) n = 143. (b) Diagnosed for at least 1 year. (c) Korean immigrants | Own risk perception score for CHD (B&L index) | Based on physiological measures | Low perception of risks |
| D. Qualitative studies investigating risk perceptions | ||||
| Carroll et al. (2003) 18 | (a) n = 20. (b) Half of participants with CVD | Own lifetime risk of CVD (verbal, semi‐structured interview) | – | Low perception of the link between diabetes and CVD risk |
| Macaden and Clarke (2006) 24 | (a) n = 20. (b) South Asian older people living in northeast England | Perception of risks in relation to sociocultural factors (verbal, focus group interview) | – | Bias induced by sociocultural norms |
| McKenzie and Skelly (2010) 26 | (a) n = 6. (b) Diagnosed for at least 1 year. (c) Southern African American women. (d) No self‐reported CHD | Lifetime risk of CVD (verbal, semi‐structured interview) | – | Low perception of risks |
| Price et al. (2009) 29 | n = 16 | Risks of CHD (verbal, focus group interview) | – | Low perception of the link between diabetes‐related risk factors and CHD |
| E. Studies providing complementary evidence | ||||
| Kausar et al. (2013) 23 | (a) n = 100. (b) No history of psychiatric condition, cognitive impairment, any other chronic condition, terminal illness, speech or hearing problems, comorbidities such as hypertension and obesity | Own risk perception for complications (RPS‐DM) | – | Higher risk perceptions were associated with higher emotional distress; men had better knowledge of diabetes complications |
| Merz et al. (2002) 27 | n = 2008 | Own risks for CV complications (telephone survey) | – | Low perception of risks, especially in people aged > 65 years; higher risk perception for microvascular complications |
| Portnoy et al. (2014) 28 | (a) n = 83. (b) Diagnosed for at least 1 year. (c) No history of CV event or CHD | Own conditional 10‐year/lifetime risk of developing/dying from CHD (numerical, conditional on physical activity level) | UKPDS‐OM risk estimate | No agreement between perceived and calculated risks |
| Saver et al. (2014) 30 | (a) n = 202. (b) At least one additional CV risk factor | Ranking of six complications (including fatal events) by likelihood of occurrence | – | Underestimation of the likelihood of fatal events |
B&L index, Becker & Levine index 34; CHD, coronary heart disease; CV, cardiovascular; CVA, cardiovascular accident; CVD, cardiovascular disease; ESH–ESC, European Society of Hypertension–European Society of Cardiology 35; ESRD, end‐stage renal disease; MI, myocardial infarction; RPS‐DM, Risk Perception Survey – Diabetes Mellitus 31; SES, socio‐economic status; S&R risk score, Schwarzer & Renner's risk score 36; TIA, transient ischaemic accident, UKPDS‐OM, UK Prospective Diabetes Study – Outcomes Model (UKPDS 56).