Can patients be accurately assessed for familial hypercholesterolaemia in primary care?

Damon Bell, Andrew Kirke, Rita Barbour, Lynda Southwell, Jing Pang, Sally Burrows, Gerald Watts

    Research output: Contribution to journalArticle

    15 Citations (Scopus)

    Abstract

    © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Objective: Familial Hypercholesterolaemia (FH) is the most prevalent monogenic condition causing premature coronary artery disease, although the majority of individuals remain undiagnosed. We sought to investigate whether individuals with FH could be accurately identified in primary care. Methods: The Dutch Lipid Clinic Network Criteria scores (DLCNCS) assessed by general practitioners (GPs) were compared with DLCNCS assessed by specialists using primary care data in 153 individuals. Thirty individuals with DLCNCS ≥4 underwent specialist review and genetic testing. Clinical FH was defined as DLCNCS ≥6, encompassing the probable and definite FH categories. Results: GPs correctly classified 39 (86.7%) individuals with 'clinical FH', and 32 (94%) with 'unlikely FH' relative to specialists. Lin's concordance correlation coefficient was high (0.832 (0.783 - 0.881), p<0.001) between specialist and GPs, with an overall agreement of 83.6%, κ 0.744 (0.642 - 0.831). After specialist review, 15 individuals (50%) were diagnosed with clinical FH, four (26.7%) had FH mutations. GPs correctly classified 12 (80%) of these individuals with clinical FH. Conclusion: GPs can accurately identify individuals at high and low risk of FH using the DLCNCS, which may augment opportunistic FH detection in the community. Increased education may enhance the diagnostic accuracy of FH in primary care.
    Original languageEnglish
    Pages (from-to)1153-1157
    JournalHeart, Lung and Circulation
    Volume23
    Issue number12
    DOIs
    Publication statusPublished - 2014

    Fingerprint

    Hyperlipoproteinemia Type II
    Primary Health Care
    General Practitioners
    Lipids
    Genetic Testing
    New Zealand
    Coronary Artery Disease
    Thorax

    Cite this

    @article{8e6c72e3a95b45f5a54139392e71cf93,
    title = "Can patients be accurately assessed for familial hypercholesterolaemia in primary care?",
    abstract = "{\circledC} 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Objective: Familial Hypercholesterolaemia (FH) is the most prevalent monogenic condition causing premature coronary artery disease, although the majority of individuals remain undiagnosed. We sought to investigate whether individuals with FH could be accurately identified in primary care. Methods: The Dutch Lipid Clinic Network Criteria scores (DLCNCS) assessed by general practitioners (GPs) were compared with DLCNCS assessed by specialists using primary care data in 153 individuals. Thirty individuals with DLCNCS ≥4 underwent specialist review and genetic testing. Clinical FH was defined as DLCNCS ≥6, encompassing the probable and definite FH categories. Results: GPs correctly classified 39 (86.7{\%}) individuals with 'clinical FH', and 32 (94{\%}) with 'unlikely FH' relative to specialists. Lin's concordance correlation coefficient was high (0.832 (0.783 - 0.881), p<0.001) between specialist and GPs, with an overall agreement of 83.6{\%}, κ 0.744 (0.642 - 0.831). After specialist review, 15 individuals (50{\%}) were diagnosed with clinical FH, four (26.7{\%}) had FH mutations. GPs correctly classified 12 (80{\%}) of these individuals with clinical FH. Conclusion: GPs can accurately identify individuals at high and low risk of FH using the DLCNCS, which may augment opportunistic FH detection in the community. Increased education may enhance the diagnostic accuracy of FH in primary care.",
    author = "Damon Bell and Andrew Kirke and Rita Barbour and Lynda Southwell and Jing Pang and Sally Burrows and Gerald Watts",
    year = "2014",
    doi = "10.1016/j.hlc.2014.06.015",
    language = "English",
    volume = "23",
    pages = "1153--1157",
    journal = "Heart, Lung & Circulation",
    issn = "1444-2892",
    publisher = "Academic Press",
    number = "12",

    }

    Can patients be accurately assessed for familial hypercholesterolaemia in primary care? / Bell, Damon; Kirke, Andrew; Barbour, Rita; Southwell, Lynda; Pang, Jing; Burrows, Sally; Watts, Gerald.

    In: Heart, Lung and Circulation, Vol. 23, No. 12, 2014, p. 1153-1157.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Can patients be accurately assessed for familial hypercholesterolaemia in primary care?

    AU - Bell, Damon

    AU - Kirke, Andrew

    AU - Barbour, Rita

    AU - Southwell, Lynda

    AU - Pang, Jing

    AU - Burrows, Sally

    AU - Watts, Gerald

    PY - 2014

    Y1 - 2014

    N2 - © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Objective: Familial Hypercholesterolaemia (FH) is the most prevalent monogenic condition causing premature coronary artery disease, although the majority of individuals remain undiagnosed. We sought to investigate whether individuals with FH could be accurately identified in primary care. Methods: The Dutch Lipid Clinic Network Criteria scores (DLCNCS) assessed by general practitioners (GPs) were compared with DLCNCS assessed by specialists using primary care data in 153 individuals. Thirty individuals with DLCNCS ≥4 underwent specialist review and genetic testing. Clinical FH was defined as DLCNCS ≥6, encompassing the probable and definite FH categories. Results: GPs correctly classified 39 (86.7%) individuals with 'clinical FH', and 32 (94%) with 'unlikely FH' relative to specialists. Lin's concordance correlation coefficient was high (0.832 (0.783 - 0.881), p<0.001) between specialist and GPs, with an overall agreement of 83.6%, κ 0.744 (0.642 - 0.831). After specialist review, 15 individuals (50%) were diagnosed with clinical FH, four (26.7%) had FH mutations. GPs correctly classified 12 (80%) of these individuals with clinical FH. Conclusion: GPs can accurately identify individuals at high and low risk of FH using the DLCNCS, which may augment opportunistic FH detection in the community. Increased education may enhance the diagnostic accuracy of FH in primary care.

    AB - © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Objective: Familial Hypercholesterolaemia (FH) is the most prevalent monogenic condition causing premature coronary artery disease, although the majority of individuals remain undiagnosed. We sought to investigate whether individuals with FH could be accurately identified in primary care. Methods: The Dutch Lipid Clinic Network Criteria scores (DLCNCS) assessed by general practitioners (GPs) were compared with DLCNCS assessed by specialists using primary care data in 153 individuals. Thirty individuals with DLCNCS ≥4 underwent specialist review and genetic testing. Clinical FH was defined as DLCNCS ≥6, encompassing the probable and definite FH categories. Results: GPs correctly classified 39 (86.7%) individuals with 'clinical FH', and 32 (94%) with 'unlikely FH' relative to specialists. Lin's concordance correlation coefficient was high (0.832 (0.783 - 0.881), p<0.001) between specialist and GPs, with an overall agreement of 83.6%, κ 0.744 (0.642 - 0.831). After specialist review, 15 individuals (50%) were diagnosed with clinical FH, four (26.7%) had FH mutations. GPs correctly classified 12 (80%) of these individuals with clinical FH. Conclusion: GPs can accurately identify individuals at high and low risk of FH using the DLCNCS, which may augment opportunistic FH detection in the community. Increased education may enhance the diagnostic accuracy of FH in primary care.

    U2 - 10.1016/j.hlc.2014.06.015

    DO - 10.1016/j.hlc.2014.06.015

    M3 - Article

    VL - 23

    SP - 1153

    EP - 1157

    JO - Heart, Lung & Circulation

    JF - Heart, Lung & Circulation

    SN - 1444-2892

    IS - 12

    ER -