How do GPs use clinical information in their judgements of heart failure? A clinical judgement analysis study.
OBJECTIVE
To study general practitioners' (GP) clinical diagnoses of heart failure.


METHODS
A Clinical Judgement Analysis study.


METHODS
Primary health care.


METHODS
Twenty-seven GPs from nine health centres in Stockholm County.


METHODS
Forty-five case vignettes, based on actual patients from two health centres in Stockholm, were presented to each GP. For each case vignette, the GPs judged the probability of heart failure.


METHODS
The GPs' assessments of the probability of heart failure in the case vignettes. The GPs' utilization of clinical information in their judgement strategies, as measured by the regression coefficients in a multiple regression equation, with the probability assessments as dependent and the clinical criteria as independent variables.


RESULTS
The variation between the GPs' assessments of the probability of heart failure was considerable. The judgemental strategies differed between the doctors, the most important variables for most of them being lung and heart X-rays and a history of myocardial infarction.


CONCLUSIONS
With new treatment recommendations, it has become increasingly important to identify patients with heart failure. This study demonstrates large differences in GPs' diagnoses of heart failure. An important source of this variation is the differences in how they make use of clinical information.
Skånér
Y
Y
Södra Station Health Centre, Stockholm, Sweden.
Strender
L E
LE
Bring
J
J
D000368:Aged; D000369:Aged, 80 and over; D003955:Diagnostic Tests, Routine; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D013548:Sweden