Analysing the concept of diagnostic inertia in hypertension: a cross-sectional study.
Int J Clin Pract
; 70(7): 619-24, 2016 Jul.
Article
em En
| MEDLINE
| ID: mdl-27163781
ABSTRACT
AIMS:
The aim of this study was to quantify diagnostic inertia (DI) when the physician fails to diagnose hypertension and determine its associated factors.METHODS:
This cross-sectional, observational study involved all patients without a diagnosis of hypertension who had their blood pressure (BP) measured at least three times during the second half of 2010 (N = 48,605). Patients with altered mean BP figures (≥ 140/90 mmHg) were considered to experience DI. Secondary variables gender, atrial fibrillation, diabetes mellitus, dyslipidemia, cardiovascular disease, age and the physician having attended a cardiovascular training course (ESCARVAL). Associated factors were assessed by multivariate logistic regression analysis.RESULTS:
Diagnostic inertia was present in 6450 patients (13.3%, 95% CI 13.0-13.6%). Factors significantly associated with DI were male gender (OR = 1.46, 95% CI 1.37-1.55, p < 0.001), atrial fibrillation (OR = 0.73, 95% CI 0.58-0.92, p = 0.007), the ESCARVAL cardiovascular course (OR = 0.88, 95% CI 0.81-0.96, p = 0.005), diabetes mellitus (OR = 0.93, 95% CI 0.87-0.99, p = 0.016), cardiovascular disease (OR = 0.77, 95% CI 0.67-0.88, p < 0.001) and older age (years) (18-44âOR = 1; 45-59âOR = 12.45, 95% CI 11.11-13.94; 60-74âOR = 18.11, 95% CI 16.30-20.12; ≥ 75âOR = 20.43, 95% CI 18.34-22.75; p < 0.001). The multivariate model had an area under the ROC curve of 0.81 (95% CI 0.80-0.81, p < 0.001).CONCLUSIONS:
This study will help clinical researchers differentiate between the two forms of DI (interpretation of a positive screening test and interpretation of positive diagnostic criteria). The results found here in patients with hypertension suggest that this problem is prevalent, and that a set of associated factors can explain the outcome well (AUC>0.80).
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hipertensão
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article