Analysing the concept of diagnostic inertia in hypertension: a cross-sectional study
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Other documents of the author: Pallarés-Carratalá, Vicente; Bonig-Trigueros, Irene; Palazón-Bru, Antonio; Lorenzo-Piqueres, A.; Valls Roca, Francisco; Orozco Beltrán, Domingo; Gil-Guillén, Vicente F
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comunitat-uji-handle2:10234/36080
comunitat-uji-handle3:10234/36082
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Title
Analysing the concept of diagnostic inertia in hypertension: a cross-sectional studyAuthor (s)
Date
2016Publisher
WileyBibliographic citation
Pallares-Carratalá, V., Bonig-Trigueros, I., Palazón-Bru, A., Lorenzo-Piqueres, A., Valls-Roca, F., Orozco-Beltrán, D., Gil-Guillen, V. F., Steering Committee ESCARVAL Study (2016), Analysing the concept of diagnostic inertia in hypertension: a cross-sectional study. International Journal of Clinical Practice, 70: 619–624. doi: 10.1111/ijcp.12825Type
info:eu-repo/semantics/articlePublisher version
http://onlinelibrary.wiley.com/doi/10.1111/ijcp.12825/abstractAbstract
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 ... [+]
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) (18–44[RIGHTWARDS ARROW]OR = 1; 45–59[RIGHTWARDS ARROW]OR = 12.45, 95% CI: 11.11–13.94; 60–74[RIGHTWARDS ARROW]OR = 18.11, 95% CI: 16.30–20.12; ≥ 75[RIGHTWARDS ARROW]OR = 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). [-]
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International Journal of Clinical Practice Volume 70, Issue 7, pages 619–624, July 2016Rights
"This is the peer reviewed version of the following article: Pallares-Carratalá, V., Bonig-Trigueros, I., Palazón-Bru, A., Lorenzo-Piqueres, A., Valls-Roca, F., Orozco-Beltrán, D., Gil-Guillen, V. F., Steering Committee ESCARVAL Study (2016), Analysing the concept of diagnostic inertia in hypertension: a cross-sectional study. International Journal of Clinical Practice, 70: 619–624. doi: 10.1111/ijcp.12825, which has been published in final form at http://dx.doi.org/10.1111/ijcp.12825. This article may be used for non commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."
© 2016 John Wiley & Sons Ltd
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