Epidemiological usefulness of population-based electronic clinical records in primary care: estimation of the prevalence of chronic diseases.

BACKGROUND: Chronic health problems are the main cause of disease, disability and death in developed countries, and their prevalence is increasing. OBJECTIVE: To estimate the prevalence of selected chronic illnesses based on electronic clinical records in primary care (ECRPC) and to assess its usefulness for epidemiological research, by comparing ECRPC data against those reported by a contemporary health survey. DESIGN: Descriptive cross-sectional study. SETTING: All primary care medical consultations in the Madrid Regional Public Health System (PHS). SUBJECTS: A total of 23 535 182 ECRPC-registered episodes of illness, generated by PHS patients over 15 years of age seeking medical care during 2005-06. MAIN OUTCOME MEASURES: Prevalences of chronic diseases estimated on the basis of medically examined cases registered in ECRPC and morbidity as reported by a contemporary health survey covering the same geographic area. RESULTS: A total of 52.5% of the adult population had some chronic health problem. The highest overall prevalences were hypertension (14.8%), mental disorders (12.0%) and allergy (11.6%). Prevalences were generally highest among women, elderly and the native population. Depending on the specific disease, ECRPC-based prevalences were similar to (e.g. diabetes), higher (e.g. chronic skin problems) or lower (e.g. asthma and dyslipidaemia) than those reported by surveys, with certain age- and sex-related variations. CONCLUSIONS: Prevalences estimated from ECRPC and survey data present variations depending on the disease, age and sex. Both data sources provide complementary information about chronic disease prevalence. ECRPC have the advantage of generating an ongoing standardized register and entailing no additional effort for health professionals.

[Rapid diagnosis of streptococcal pharyngo-tonsillitis in a primary care unit]. / Diagnóstico rápido de faringoamigdalitis estreptocócica en un equipo de atención primaria.

One of the main consulting motives in ambulatory pediatric practice is acute pharyngotonsillitis. This work values the efficacy of a test to confirm rapid diagnosis (30 minutes) of streptococcal pharyngitis. Authors selected 100 children in a office of primary health care whose ages were between two and seven years, from February to July in 1986. They have considered classical clinical symptoms of pharyngitis and have applied a throat culture and rapid test in all. After comparing test results and culture results, obtained sensibility and specificity have been 80% and 95% (p less than 0.01) respectively. According to these results, they believe on the necessity of a test that permits a rapid diagnosis and which enables to treat acute pharyngitis in a more suitable way in ambulatory pediatrics.