A new electronic screening tool for identifying risk of familial hypercholesterolaemia in general practice

Lakkhina Troeung, D. Arnold-Reed, W.C.S. Ping-Delfos, Gerald Watts, Jing Pang, M. Lugonja, M. Bulsara, D. Mortley, M. James, T. Brett

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25 Citations (Scopus)

Abstract

Objective To evaluate the performance of a new electronic screening tool (TARB-Ex) in detecting general practice patients at potential risk of familial hypercholesterolaemia (FH). Methods Medical records for all active patients seen between 2012 and 2014 (n=3708) at a large general practice in Perth, Western Australia were retrospectively screened for potential FH risk using TARB-Ex. Electronic extracts of medical records for patients identified with potential FH risk (defined as Dutch Lipid Clinic Network Criteria (DLCNC) score ≥5) through TARB-Ex were reviewed by a general practitioner (GP) and lipid specialist. High-risk patients were recalled for clinical assessment to determine phenotypic FH diagnosis. Performance was evaluated against a manual record review by a GP in the subset of 360 patients with high blood cholesterol (cholesterol ≥7 mmol/L or low-density lipoprotein cholesterol ≥4.0 mmol/L). Results Thirty-two patients with DLCNC score ≥5 were identified through electronic screening compared with 22 through GP manual review. Sensitivity was 95.5% (95% CI 77.2% to 99.9%), specificity was 96.7% (95% CI 94.3% to 98.3%), negative predictive accuracy was 99.7% (95% CI 98.3% to 100%) and positive predictive accuracy was 65.6% (95% CI 46.9% to 8%). Electronic screening was completed in 10 min compared with 60 h for GP manual review. 10 of 32 patients (31%) were considered high risk and recalled for clinical assessment. Six of seven patients (86%) who attended clinical assessment were diagnosed with phenotypic FH on examination. Conclusions TARB-Ex screening is a time-effective and cost-effective method of systematically identifying potential FH risk patients from general practice records for clinical follow-up.
Original languageEnglish
Pages (from-to)855-861
JournalHeart
Volume102
Issue number11
DOIs
Publication statusPublished - 2016

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    Troeung, L., Arnold-Reed, D., Ping-Delfos, W. C. S., Watts, G., Pang, J., Lugonja, M., Bulsara, M., Mortley, D., James, M., & Brett, T. (2016). A new electronic screening tool for identifying risk of familial hypercholesterolaemia in general practice. Heart, 102(11), 855-861. https://doi.org/10.1136/heartjnl-2015-308824