title: Choosing the preventive workload in general practice: practical application of the Coronary Prevention Group guidelines and Dundee coronary risk-disk.
abstract: OBJECTIVE
  To determine the workload implications for general practice of the Coronary Prevention Group and British Heart Foundation action plan for preventing heart disease.
  
  
  METHODS
  Computer simulation of plan, including calculation of Dundee risk scores, with data from OXCHECK trial.
  
  
  METHODS
  4759 patients aged 35-64 who had health checks during 1989-91.
  
  
  METHODS
  Effect of using different risk scores as thresholds on workload and coverage of patients at known risk. Thresholds of 6-20 were used for cholesterol screening (nearset) and 4-16 for special care (preset).
  
  
  RESULTS
  On the basis of workload a nearset of 8 and preset of 12 would be reasonable. This implies cholesterol measurement in 1794 (37.7%) patients and special care in 1074 (22.6%). However, many patients with single risk factors were not allocated to special care at these thresholds: 11 (37.9%) patients with cholesterol concentrations > or = 10 mmol/l, 21 (33.9%) with systolic pressure > or = 180 mm Hg, and 213 (40.7%) heavy smokers (> 20 cigarettes/day) were missed. The distribution of scores was similar in those at established clinical risk, those with family history of heart disease, and others.
  
  
  CONCLUSIONS
  The guidelines may help to make best use of resources within specific age-sex groups but sound protocols for unifactorial risk assessment and modification remain essential.
authors.affiliation: University of Oxford, Department of Public Health and Primary Care, Radcliffe Infirmary.
authors.forename: T
authors.initials: T
authors.lastname: Randall
authors.forename: J
authors.initials: J
authors.lastname: Muir
authors.forename: D
authors.initials: D
authors.lastname: Mant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000517:prevention & control*; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012606:Scotland; D016526:Workload
chemical_list: D002784:Cholesterol