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A new electronic screening tool for identifying risk of familial hypercholesterolaemia in general practice.

Authors :
Troeung, Lakkhina
Arnold-Reed, Diane
Chan She Ping-Delfos, Wendy
Watts, Gerald F.
Jing Pang
Lugonja, Marija
Bulsara, Max
Mortley, David
James, Matthew
Brett, Tom
Pang, Jing
Source :
Heart; Jun2016, Vol. 102 Issue 11, p855-861, 7p, 2 Diagrams, 3 Charts, 1 Graph
Publication Year :
2016

Abstract

<bold>Objective: </bold>To evaluate the performance of a new electronic screening tool (TARB-Ex) in detecting general practice patients at potential risk of familial hypercholesterolaemia (FH).<bold>Methods: </bold>Medical records for all active patients seen between 2012 and 2014 (n=3708) at a large general practice in Perth, Western Australia were retrospectively screened for potential FH risk using TARB-Ex. Electronic extracts of medical records for patients identified with potential FH risk (defined as Dutch Lipid Clinic Network Criteria (DLCNC) score ≥5) through TARB-Ex were reviewed by a general practitioner (GP) and lipid specialist. High-risk patients were recalled for clinical assessment to determine phenotypic FH diagnosis. Performance was evaluated against a manual record review by a GP in the subset of 360 patients with high blood cholesterol (cholesterol ≥7 mmol/L or low-density lipoprotein cholesterol ≥4.0 mmol/L).<bold>Results: </bold>Thirty-two patients with DLCNC score ≥5 were identified through electronic screening compared with 22 through GP manual review. Sensitivity was 95.5% (95% CI 77.2% to 99.9%), specificity was 96.7% (95% CI 94.3% to 98.3%), negative predictive accuracy was 99.7% (95% CI 98.3% to 100%) and positive predictive accuracy was 65.6% (95% CI 46.9% to 8%). Electronic screening was completed in 10 min compared with 60 h for GP manual review. 10 of 32 patients (31%) were considered high risk and recalled for clinical assessment. Six of seven patients (86%) who attended clinical assessment were diagnosed with phenotypic FH on examination.<bold>Conclusions: </bold>TARB-Ex screening is a time-effective and cost-effective method of systematically identifying potential FH risk patients from general practice records for clinical follow-up. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13556037
Volume :
102
Issue :
11
Database :
Complementary Index
Journal :
Heart
Publication Type :
Academic Journal
Accession number :
116203084
Full Text :
https://doi.org/10.1136/heartjnl-2015-308824