Availability and Quality of Coronary Heart Disease Family History in Primary Care Medical Records: Implications for Cardiovascular Risk Assessment
Availability and Quality of Coronary Heart Disease Family History in Primary Care Medical Records: Implications for Cardiovascular Risk Assessment
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DOI：
10.1371/journal.pone.0081998
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发表时间：
2014-01-09
期刊：
影响因子：
3.7
通讯作者：
Qureshi, Nadeem
中科院分区：
文献类型：
--
作者：
Dhiman, Paula;Kai, Joe;Qureshi, Nadeem
背景资料：越来越多的人认识到利用早发性疾病家族史数据评估疾病风险的潜力，特别是在冠心病（CHD）风险评分方面。然而，在初级保健records.Aim的家庭健康信息的质量是不清楚的：为了评估的可用性和质量的冠心病家族史记录在电子初级保健recordsDesign：横断面研究设置：537英国家庭的做法有助于健康改善网络数据库。数据来自1998年1月1日至2008年12月31日期间在其当前诊所注册至少1年的20岁或以上患者。冠心病家族史记录的可用性和质量进行了评估，采用多层次logistic回归和有序logistic regression relevants.Results：在一个横截面的1,504,535例患者中，19%有积极或消极的冠心病家族史记录。多水平Logistic回归显示，50-59岁的患者记录家族史的几率高于20-29岁的患者（OR：1.23（1.21至1.25）），但大多数贫困患者的几率低于最低贫困患者（OR：0.86（0.85至0.88））。在140，058例记录有阳性家族史的患者中（占总队列的9%），45%的患者可获得发病年龄;仅11%的记录可提供详细说明发病年龄和相对受影响的数据。多水平有序Logistic回归证实，没有统计学关联的质量，家族史记录和年龄，性别，剥夺和年registration.Conclusion：冠心病家族史记录在一个小比例的初级保健记录，并积极的家族史记录的细节是不够的，以评估家族风险或填充心血管风险评估工具。数据采集需要改进，特别是对于那些最有可能从CHD风险评估中获益的弱势患者。
Background: The potential to use data on family history of premature disease to assess disease risk is increasingly recognised, particularly in scoring risk for coronary heart disease (CHD). However the quality of family health information in primary care records is unclear.Aim: To assess the availability and quality of family history of CHD documented in electronic primary care recordsDesign: Cross-sectional studySetting: 537 UK family practices contributing to The Health Improvement Network database.Method: Data were obtained from patients aged 20 years or more, registered with their current practice between 1st January 1998 and 31st December 2008, for at least one year. The availability and quality of recorded CHD family history was assessed using multilevel logistic and ordinal logistic regression respectively.Results: In a cross-section of 1,504,535 patients, 19% had a positive or negative family history of CHD recorded. Multilevel logistic regression showed patients aged 50-59 had higher odds of having their family history recorded compared to those aged 20-29 (OR: 1.23 (1.21 to 1.25)), however most deprived patients had lower odds compared to those least deprived (OR: 0.86 (0.85 to 0.88)). Of the 140,058 patients with a positive family history recorded (9% of total cohort), age of onset was available in 45%; with data specifying both age of onset and relative affected available in only 11% of records. Multilevel ordinal logistic regression confirmed no statistical association between the quality of family history recording and age, gender, deprivation and year of registration.Conclusion: Family history of CHD is documented in a small proportion of primary care records; and where positive family history is documented the details are insufficient to assess familial risk or populate cardiovascular risk assessment tools. Data capture needs to be improved particularly for more disadvantaged patients who may be most likely to benefit from CHD risk assessment.