Selective opportunistic screening for hypercholesterolemia in primary care practice

Brian Hutchison*, Stephen Birch, C. Edward Evans, Laurie J. Goldsmith, Barbara A. Markham, John Frank, Michael Paterson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To assess the performance of selective opportunistic screening in a primary care group practice. Design: Cross sectional survey of coronary heart disease risk factors and retrospective chart audit of cholesterol testing. Setting: Capitation-funded primary care group practice in Ontario, Canada. Subjects: 7785 enrolled patients between the ages of 20 and 69 years. Intervention: Protocol-based selective opportunistic screening program for hypercholesterolemia of 45 months duration. Main Outcome Measures: Targeting (proportion of screening tests that were appropriate), coverage (proportion of those meeting screening criteria who had a screening test performed), over-screening (proportion of those not meeting screening criteria who had a screening test performed), and screening ratio (likelihood that a screening test was performed on an individual who met screening criteria rather than one who failed to meet screening criteria). Results: 64.7% of patients tested met the practice criteria for screening. 37.7% of patients who met the practice screening criteria were tested and 24.9% of those not meeting practice screening criteria had a cholesterol test performed. The screening ratio was 1.52. Conclusion: Our findings bring into question the effectiveness of opportunistic approaches to preventive care.

Original languageEnglish
Pages (from-to)817-825
Number of pages9
JournalJournal of Clinical Epidemiology
Volume51
Issue number10
DOIs
Publication statusPublished - 1 Oct 1998

Keywords

  • Hypercholesterolemia
  • Performance appraisal
  • Primary care
  • Screening

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