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Screening for Coronary Calcification—Reply
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In Reply: We generally agree with Drs Sabaté and Yach that a dynamic process of adherence requiring individualized attention, among other factors, is necessary to enact behavioral change. We also agree that the process of behavioral interventions by experienced and appropriately trained clinicians is a first step in the process of motivation to change. However, we also believe that alternative approaches to enhance behavioral interventions should continue to be tested. Current methods to modify risk in primary prevention involve resource-intensive efforts whose efficacy and cost-effectiveness for reducing morbidity and mortality remains largely unknown. Such objective information about preclinical disease in the context of an ongoing patient-physician relationship might help to support behavioral interventions. For example, in a subgroup of participants with cardiac calcification in our study, there was a trend toward improved risk profile when calcification data was included in the process of care. We suspect that the detection and . . . [Full Text of this Article]
Patrick G. O'Malley, MD, MPH;
Allen J. Taylor, MD
Department of Medicine
Walter Reed Army Medical Center
Washington, DC
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