Identifying patients with ischaemic heart disease in general practice: cross sectional study of paper and computerised medical records
Key result
A computer search combining the G3 Read code with prescriptions for nitrates, aspirin, atenolol, digoxin, or statins identified 96% of patients with ischaemic heart disease.
Why the study?
Does adding other cardiovascular drugs to a computer search strategy improve the identification of patients with ischaemic heart disease in general practice?
Population
1,680 patients aged 45 or older (1 in 40 random sample) from 11 general practices in south London.
Comparison
Computer search strategy adding aspirin… vs Computer search for Read code and nitrate…
Design
Cross-sectional
Authors
Discussion
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Implication
May enhance electronic identification of ischaemic heart disease in primary care; leaves open prospective validation before routine use.
Study Design
Type
Cross-Sectional (n=1,680)
Multicenter
Yes
Structured PICO
Does adding other cardiovascular drugs to a computer search strategy improve the identification of patients with ischaemic heart disease in general practice?
P
Population
1,680 patients aged 45 years or older from 11 general practices in south London whose medical records were reviewed to identify ischaemic heart disease.
E
Exposure
Computer search strategy adding aspirin, atenolol, digoxin, or a statin to Read code (G3) and nitrate prescription
C
Comparator
Computer search for Read code (G3) and nitrate prescription alone
O
Outcome
Numbers of patients identified with ischaemic heart disease
Main Result
Effect estimate: 96% sensitivity (95% CI 89-100)
Adding common cardiovascular medications to computer search strategies significantly improves the sensitivity of identifying patients with ischemic heart disease in primary care.
Limitations
- Coding and prescribing policies of the studied practices may not be generalisable to the rest of the country.
- Results of the searches using atenolol, digoxin, or statin depend on a very few cases.
- The study was conducted on EMIS computer systems only, and other systems may have less developed search capabilities.
Cite This Study
Gray et al. (2000) conducted a cross-sectional in Ischaemic heart disease (n=1,680). Computer search strategy (G3 Read code and/or cardiac drugs) vs. Manual review of paper medical records was evaluated on Sensitivity of computer search for G3 Read code or 5 additional drugs (nitrates, aspirin, atenolol, digoxin, or statins) (96% sensitivity, 95% CI 89-100). A computer search combining the G3 Read code with prescriptions for nitrates, aspirin, atenolol, digoxin, or statins identified 96% of patients with ischaemic heart disease.