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GPs' familiarity with and use of cardiovascular clinical prediction rules: a UK survey study
Jong-Wook Ban1, Rafael Perera2, Richard Stevens2
1Evidence-Based Health Care Programme, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK jong-wook.ban@conted.ox.ac.uk.
Insights
General practitioners (GPs) in the UK show significant changes in their recognition and use of cardiovascular clinical prediction rules (CPRs). Integrating CPRs into guidelines and software could further improve their adoption and application in practice.
Area of Science:
- Cardiology
- General Practice
- Health Informatics
Background:
- Clinical prediction rules (CPRs) aid general practitioners (GPs) in managing cardiovascular disease.
- A 2014 survey assessed UK GPs' awareness and use of CPRs, but newer rules have emerged.
- Current recognition and utilization of cardiovascular CPRs among GPs remain unclear.
Purpose of the Study:
- To identify cardiovascular CPRs recognized and used by UK GPs.
- To assess changes in GPs' familiarity and use of these CPRs over time.
- To understand the reasons behind CPR usage by GPs.
Main Methods:
- An online survey of 401 UK GPs was conducted.
- Methods mirrored a 2014 survey for comparable analysis.
- GPs reported familiarity, frequency of use, and reasons for using cardiovascular CPRs.
Main Results:
- High familiarity reported for QRISK, ABCD, CHADS, HAS-BLED, and Wells scores (DVT/PE).
- Proportions of GPs using these CPRs ranged from 65.1% to 97.3%.
- Significant increases in use observed for QRISK, ABCD, CHADS, and Wells scores; decreases noted for JBS, Framingham, and New Zealand tables. CPRs primarily used for guiding therapy and referral.
Conclusions:
- GPs' familiarity and use of cardiovascular CPRs have substantially evolved.
- Integration of CPRs into clinical guidelines and practice software is recommended.
- Enhanced integration may further increase CPR adoption and consistent application.
Background:
Clinical prediction rules (CPRs) can help general practitioners (GPs) address challenges in cardiovascular disease. A survey published in 2014 evaluated GPs' awareness and use of CPRs in the UK. However, many new CPRs have been published since and it is unknown which cardiovascular CPRs are currently recognised and used.
Aim:
To identify cardiovascular CPRs recognised and used by GPs, and to assess how GPs' familiarity and use have changed over time.
Design & Setting:
An online survey of GPs in the UK was undertaken.
Method:
Using comparable methods to the 2014 survey, GPs were recruited from a network of doctors in the UK. They were asked how familiar they were with cardiovascular CPRs, how frequently they used them, and why they used them. The results were compared with the 2014 survey.
Results:
Most of 401 GPs were familiar with QRISK scores, ABCD scores, CHADS scores, HAS-BLED score, Wells scores for deep vein thrombosis, and Wells scores for pulmonary embolism. The proportions of GPs using these CPRs were 96.3%, 65.1%, 97.3%, 93.0%, 92.5%, and 82.0%, respectively. GPs' use increased by 31.2% for QRISK scores, by 13.5% for ABCD scores, by 54.6% for CHADS scores, by 33.2% for Wells scores for deep vein thrombosis, and by 43.6% for Wells scores for pulmonary embolism; and decreased by 45.9% for the Joint British Societies (JBS) risk calculator, by 38.7% for Framingham risk scores, and by 8.7% for New Zealand tables. GPs most commonly used cardiovascular CPRs to guide therapy and referral.
Conclusion:
The study found GPs' familiarity and use of cardiovascular CPRs changed substantially. Integrating CPRs into guidelines and practice software might increase familiarity and use.
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