Clinical prediction rules in practice: Review of clinical guidelines and survey of GPs

Annette Plüddemann, Emma Wallace, Clare Bankhead, Claire Keogh, Danielle Van Der Windt, Daniel Lasserson, Rose Galvin, Ivan Moschetti, Karen Kearley, Kirsty O'Brien, Sharon Sanders, Susan Mallett, Uriell Malanda, Matthew Thompson, Tom Fahey, Richard Stevens

Research output: Contribution to journalArticleResearchpeer-review

19 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)e233-e242
Number of pages10
JournalBritish Journal of General Practice
Volume64
Issue number621
DOIs
Publication statusPublished - 1 Apr 2014

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Decision Support Techniques
Guidelines
Cardiovascular Diseases
Primary Prevention
Surveys and Questionnaires
Point-of-Care Systems
Transient Ischemic Attack
Expert Testimony
Osteoporosis
Publications
Lower Extremity
Diabetes Mellitus
Stroke
Breast Neoplasms

Cite this

Plüddemann, A., Wallace, E., Bankhead, C., Keogh, C., Van Der Windt, D., Lasserson, D., ... Stevens, R. (2014). Clinical prediction rules in practice: Review of clinical guidelines and survey of GPs. British Journal of General Practice, 64(621), e233-e242. https://doi.org/10.3399/bjgp14X677860
Plüddemann, Annette ; Wallace, Emma ; Bankhead, Clare ; Keogh, Claire ; Van Der Windt, Danielle ; Lasserson, Daniel ; Galvin, Rose ; Moschetti, Ivan ; Kearley, Karen ; O'Brien, Kirsty ; Sanders, Sharon ; Mallett, Susan ; Malanda, Uriell ; Thompson, Matthew ; Fahey, Tom ; Stevens, Richard. / Clinical prediction rules in practice : Review of clinical guidelines and survey of GPs. In: British Journal of General Practice. 2014 ; Vol. 64, No. 621. pp. e233-e242.
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abstract = "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.",
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Plüddemann, A, Wallace, E, Bankhead, C, Keogh, C, Van Der Windt, D, Lasserson, D, Galvin, R, Moschetti, I, Kearley, K, O'Brien, K, Sanders, S, Mallett, S, Malanda, U, Thompson, M, Fahey, T & Stevens, R 2014, 'Clinical prediction rules in practice: Review of clinical guidelines and survey of GPs' British Journal of General Practice, vol. 64, no. 621, pp. e233-e242. https://doi.org/10.3399/bjgp14X677860

Clinical prediction rules in practice : Review of clinical guidelines and survey of GPs. / Plüddemann, Annette; Wallace, Emma; Bankhead, Clare; Keogh, Claire; Van Der Windt, Danielle; Lasserson, Daniel; Galvin, Rose; Moschetti, Ivan; Kearley, Karen; O'Brien, Kirsty; Sanders, Sharon; Mallett, Susan; Malanda, Uriell; Thompson, Matthew; Fahey, Tom; Stevens, Richard.

In: British Journal of General Practice, Vol. 64, No. 621, 01.04.2014, p. e233-e242.

Research output: Contribution to journalArticleResearchpeer-review

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.

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Plüddemann A, Wallace E, Bankhead C, Keogh C, Van Der Windt D, Lasserson D et al. Clinical prediction rules in practice: Review of clinical guidelines and survey of GPs. British Journal of General Practice. 2014 Apr 1;64(621):e233-e242. https://doi.org/10.3399/bjgp14X677860