Is population-oriented IT supported preventive care in general practice feasible? A database study.

Background: Introducing a clinical decision support system (CDSS) in general practice that provides broad support based on all available guidelines for preventive care might dramatically increase the workload of a general practitioner.

Aim: We evaluated the potential effect on workload of a CDSS that aims to support the whole breadth of preventive guidelines currently used in The Netherlands.

Methods: We analysed the guidelines of the Dutch college of General Practitioners (DCGP) for preventive activities, developed a CDSS based on the guidelines and studied the behaviour of the system on real patient data.

Electronic alerts versus on-demand decision support to improve dyslipidemia treatment: a cluster randomized controlled trial.

Background: Indirect evidence shows that alerting users with clinical decision support systems seems to change behavior more than requiring users to actively initiate the system. However, randomized trials comparing these methods in a clinical setting are lacking. We studied the effect of both alerting and on-demand decision support with respect to screening and treatment of dyslipidemia based on the guidelines of the Dutch College of General Practitioners.

User requirements rating and knowledge-level of general practitioners at the start of CholGate - a lipid management decision support project.

In the CholGate project we performed a preliminary study evaluating user requirements and knowledge level on lipid management in 40 primary care practices in The Netherlands. Practitioners rated speed, usability and completeness as important. We hope to show that the knowledge level of physicians regarding lipid management can be passively increased from its current levels by an integrated decision support system.

Cross-sectional analysis of guidelines on cardiovascular disease risk factors: going to meet the inconsistencies.

Objective: To identify the possible inconsistency of statements among the practice guidelines of the Dutch College of General Practitioners (DCGP) with respect to the management of risk factors for cardiovascular disease (CVD).

Methods: Cross-sectional analysis of all electronically available DCGP practice guidelines dealing with CVD risk factor management for statement inconsistencies and reference inconsistencies.

Results: Six DCGP guidelines out of 74 electronically available guidelines had either CVD or CVD risk factors as the subject of the guideline.

Identification of the four conventional cardiovascular disease risk factors by Dutch general practitioners.

Background: Detecting and managing the four major conventional risk factors, smoking, hypertension, diabetes mellitus, and hypercholesterolemia, is pivotal in the primary and secondary prevention of cardiovascular disease (CVD).

Objective: To assess the preventive activities of general practitioners (GPs) regarding the four conventional risk factors and the associated measurements for cardiovascular risk factors by GPs in relation to the time of the first clinical presence of CVD.

Setting: Large longitudinal general practice research database (the Integrated Primary Care Information database) in the Netherlands from September 1999 to August 2003.

Differences between statins on clinical endpoints: a population-based cohort study.

Objective: Many studies have shown differences between statins based on surrogate endpoints, but few have studied differences in reaching clinical endpoints. This study compares the risk of cardiovascular and cerebrovascular events between atorvastatin users and other statin users in daily general practice.

Research Design And Methods: A cohort study was performed in the Integrated Primary Care Information project database, a longitudinal general practice research database with electronic patient records of more than 500,000 individuals in The Netherlands.

Management of hypertension and hypercholesterolaemia in primary care in The Netherlands.

Objective: Screening, treatment and monitoring guidelines for hypertension and hypercholesterolaemia have been developed to assist physicians in providing evidence-based health care. We conducted a retrospective study to assess the management of patients with these single or combined conditions.

Research Design And Methods: This was a retrospective cohort study conducted using data from the Integrated Primary Care Information (IPCI) project based in The Netherlands.

Analysis of Dutch general practice guidelines for inconsistencies with respect to the management of cardiovascular disease risk factors.

Unlabelled: Presenting guidelines relating to cardiovascular disease (CVD) in a clinical decision support system (CDSS) is viewed as a mechanism for introducing evidence based practice in to daily practice. Analysis of guidelines on consistency is needed before constructing such a system. We analyzed 74 electronically available Dutch general practice guidelines for statement inconsistencies with respect to the management of CVD, and for each inconsistency, whether incomplete cross referencing existed between the guidelines.

Cholgate - a randomized controlled trial comparing the effect of automated and on-demand decision support on the management of cardiovascular disease factors in primary care.

Automated and on-demand decision support systems integrated into an electronic medical record have proven to be an effective implementation strategy for guidelines. Cholgate is a randomized controlled trial comparing the effect of automated and on-demand decision support on the management of cardiovascular disease factors in primary care.