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Related Experiment Videos

Selective opportunistic screening for hypercholesterolemia in primary care practice

B Hutchison1, S Birch, C E Evans

  • 1Department of Family Medicine, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.

Journal of Clinical Epidemiology
|October 8, 1998
PubMed
Summary

Selective opportunistic screening for high cholesterol in primary care showed low effectiveness. Only 37.7% of eligible patients were tested, while 24.9% of ineligible patients received cholesterol tests, questioning opportunistic preventive care strategies.

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Area of Science:

  • Primary Care Medicine
  • Preventive Cardiology
  • Health Services Research

Background:

  • Opportunistic screening for hypercholesterolemia in primary care aims to identify individuals at risk for coronary heart disease.
  • Evaluating the performance of such screening programs is crucial for optimizing preventive care delivery.

Purpose of the Study:

  • To assess the performance of a selective opportunistic screening program for hypercholesterolemia within a primary care group practice.
  • To evaluate key performance indicators including targeting, coverage, and over-screening.

Main Methods:

  • A cross-sectional survey and retrospective chart audit were conducted in a capitation-funded primary care practice in Ontario, Canada.
  • The study included 7785 enrolled patients aged 20-69 years over a 45-month period.

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  • Performance was measured by targeting, coverage, over-screening, and the screening ratio.

    • Main Results:

    • 64.7% of patients who underwent cholesterol testing met the practice's screening criteria.
    • Only 37.7% of patients meeting screening criteria were tested, while 24.9% of those not meeting criteria were tested.
    • The screening ratio was 1.52, indicating a low likelihood of appropriate screening.

    Conclusions:

    • The study findings raise concerns about the effectiveness of opportunistic screening approaches in primary care for preventive services.
    • The low coverage and significant over-screening suggest inefficiencies in the current opportunistic model.
    • Further research is needed to improve the performance of opportunistic preventive care strategies.