TY - JOUR
T1 - Clinical prediction rules in practice
T2 - Review of clinical guidelines and survey of GPs
AU - Plüddemann, Annette
AU - Wallace, Emma
AU - Bankhead, Clare
AU - Keogh, Claire
AU - Van Der Windt, Danielle
AU - Lasserson, Daniel
AU - Galvin, Rose
AU - Moschetti, Ivan
AU - Kearley, Karen
AU - O'Brien, Kirsty
AU - Sanders, Sharon
AU - Mallett, Susan
AU - Malanda, Uriell
AU - Thompson, Matthew
AU - Fahey, Tom
AU - Stevens, Richard
PY - 2014/4/1
Y1 - 2014/4/1
N2 - Background: The publication of clinical prediction rules (CPRs) studies has risen significantly. It is unclear if this reflects increasing usage of these tools in clinical practice or how this may vary across clinical areas. Aim: To review clinical guidelines in selected areas and survey GPs in order to explore CPR usefulness in the opinion of experts and use at the point of care. Design and setting: A review of clinical guidelines and survey of UK GPs. Method: Clinical guidelines in eight clinical domains with published CPRs were reviewed for recommendations to use CPRs including primary prevention of cardiovascular disease, transient ischaemic attack (TIA) and stroke, diabetes mellitus, fracture risk assessment in osteoporosis, lower limb fractures, breast cancer, depression, and acute infections in childhood. An online survey of 401 UK GPs was also conducted. Results: Guideline review: Of 7637 records screened by title and/or abstract, 243 clinical guidelines met inclusion criteria. CPRs were most commonly recommended in guidelines regarding primary prevention of cardiovascular disease (67%) and depression (67%). There was little consensus across various clinical guidelines as to which CPR to use preferentially. Survey: Of 401 responders to the GP survey, most were aware of and applied named CPRs in the clinical areas of cardiovascular disease and depression. The commonest reasons for using CPRs were to guide management and conform to local policy requirements. Conclusion: GPs use CPRs to guide management but also to comply with local policy requirements. Future research could focus on which clinical areas clinicians would most benefit from CPRs and promoting the use of robust, externally validated CPRs.
AB - Background: The publication of clinical prediction rules (CPRs) studies has risen significantly. It is unclear if this reflects increasing usage of these tools in clinical practice or how this may vary across clinical areas. Aim: To review clinical guidelines in selected areas and survey GPs in order to explore CPR usefulness in the opinion of experts and use at the point of care. Design and setting: A review of clinical guidelines and survey of UK GPs. Method: Clinical guidelines in eight clinical domains with published CPRs were reviewed for recommendations to use CPRs including primary prevention of cardiovascular disease, transient ischaemic attack (TIA) and stroke, diabetes mellitus, fracture risk assessment in osteoporosis, lower limb fractures, breast cancer, depression, and acute infections in childhood. An online survey of 401 UK GPs was also conducted. Results: Guideline review: Of 7637 records screened by title and/or abstract, 243 clinical guidelines met inclusion criteria. CPRs were most commonly recommended in guidelines regarding primary prevention of cardiovascular disease (67%) and depression (67%). There was little consensus across various clinical guidelines as to which CPR to use preferentially. Survey: Of 401 responders to the GP survey, most were aware of and applied named CPRs in the clinical areas of cardiovascular disease and depression. The commonest reasons for using CPRs were to guide management and conform to local policy requirements. Conclusion: GPs use CPRs to guide management but also to comply with local policy requirements. Future research could focus on which clinical areas clinicians would most benefit from CPRs and promoting the use of robust, externally validated CPRs.
KW - Clinical guidelines
KW - Clinical prediction rules
KW - Survey
UR - http://www.scopus.com/inward/record.url?scp=84898744653&partnerID=8YFLogxK
U2 - 10.3399/bjgp14X677860
DO - 10.3399/bjgp14X677860
M3 - Review article
C2 - 24686888
AN - SCOPUS:84898744653
SN - 0960-1643
VL - 64
SP - e233-e242
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 621
ER -