Intra-rator variability of primary care physicians in management of hyperlipidaemia.
BACKGROUND
Recent studies support the link between hyperlipidaemia and increased prevalence of cardiovascular diseases (CVDs). In Saudi Arabia, CVDs became a serious problem following rapid urbanization. The health care system in Saudi Arabia makes the primary care accessible to all.


OBJECTIVE
To assess the ability of primary care physicians to be consistent with themselves in the management of hyperlipidaemia.


METHODS
Cross-sectional.


METHODS
Family medicine department affiliated with tertiary hospital.


METHODS
Using 63 patient problem vignettes, each physician was asked, whether a patient required no treatment, dietary or drug treatment. Exact vignette cases were shown again to each physician two weeks later. The Kappa statistical test was used to measure the physician's intra-rator variability.


RESULTS
Forty-seven physicians were recruited to participate in this study. The Kappa statistics suggested an excellent intra-rator agreement by only four physicians, but a large majority, 28 physicians (62.2%) had fair to good agreement while thirteen physicians (28.9%) had poor agreement with themselves.


CONCLUSIONS
It is suggested that doctors must undergo adequate training and continuous evaluation of their skills in the management of hyperlipidaemia. Use of vignettes, might be a good method in assessing continuous medical education.
Al-Gelban
Khalid S
KS
Department of Family and Community Medicine, College of Medicine and Medical Sciences, King Khalid University, P.O. Box 641, Abha, Saudi Arabia. khalidgelban@hotmail.com
D000328:Adult; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D005194:Family Practice / Q000592:standards*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D006949:Hyperlipidemias / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010044:Outpatient Clinics, Hospital; D010821:Physicians, Family / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012529:Saudi Arabia; D011795:Surveys and Questionnaires