Familiarity and use of cardiovascular clinical prediction rules: A survey of general practitioners

Talk Code: 
D.7
Presenter: 
Ban Jong-Wook
Twitter: 
Co-authors: 
Rafael Perera, Richard Stevens
Author institutions: 
University of Oxford

Problem

Clinical prediction rules (CPRs) can help general practitioners (GPs) address challenges in cardiovascular disease. Although many cardiovascular CPRs exist, few have been broadly used because of inefficiencies in CPR development. It is unknown which cardiovascular CPRs are currently recognized and used by GPs. Therefore, we aimed to identify cardiovascular CPRs recognized and used by GPs, and to assess how GPs’ familiarity and use have changed.

Approach

An online survey of GPs in the UK was conducted. We recruited a geographically representative sample of GPs from Doctors.net.uk. We asked participants how familiar they were with, how frequently they used, and why they used cardiovascular CPRs. We compared our results with a survey conducted in 2014.

Findings

Most 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 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.

Consequences

We found GPs’ familiarity and use of cardiovascular CPRs changed substantially in the UK. Integrating cardiovascular CPRs into guidelines and EHRs might increase familiarity and use.

Submitted by: 
Ban Jong-Wook
Funding acknowledgement: 
This study was funded by the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Oxford, the National Institute for Health Research (NIHR).