Clinical diagnosis of heart failure by primary care physicians was frequently false-positive, with 34% of newly diagnosed patients classified as 'unlikely' to have heart failure by standard criteria.
Observational (n=88)
How valid is the clinical diagnosis of heart failure made by primary health care physicians compared to standardized criteria?
False-positive diagnosis of heart failure is common in primary care, particularly in women, and is often confounded by obesity, unrecognized myocardial ischemia, and pulmonary diseases.
Validity of heart failure (HF) diagnosis was studied in 88 patients (37 men and 51 women), aged 45-74 (mean 61) years, in whom HF diagnosis had been newly made by primary health care physicians. Boston criteria for HF and a supplementary classification, based on information from clinical examinations and a 6-month follow-up, were used to define HF diagnosis as 'definite', 'possible' or 'unlikely'. Twenty-eight (32%) patients (21 men and seven women) had 'definite' HF and 46 (52%) (28 men and 18 women) had either 'definite' or 'possible' HF by both classifications. In 30 (34%) patients (six men and 24 women) HF diagnosis was 'unlikely' by both classifications. In conclusion, false-positive diagnosis of HF was common in primary health care, and HF diagnosis was more difficult in women than in men. Obesity, unrecognized symptomatic myocardial ischaemia without HF and pulmonary diseases were the most important conditions leading to false-positive HF diagnosis.
Remes et al. (Fri,) conducted a observational in Heart failure (n=88). Clinical diagnosis by primary care physicians vs. Boston criteria and supplementary classification was evaluated on Validity of heart failure diagnosis ('definite', 'possible', or 'unlikely'). Clinical diagnosis of heart failure by primary care physicians was frequently false-positive, with 34% of newly diagnosed patients classified as 'unlikely' to have heart failure by standard criteria.