Association of physicians' accuracy in recording with quality of care in cardiovascular medicine.
BACKGROUND
Physicians' adherence to cardiovascular (CV) guidelines has been found to be poor. In this regard, accuracy in keeping medical records could play an important role. This study was devised to describe which data are present in medical records from a large sample of physicians and to investigate the association and the link between completeness in recording and clinical appropriateness.


METHODS
The data extracted from medical records of 1078 doctors (general practitioners, cardiologists, and diabetologists) were analyzed, with a focus on CV prevention. The percentage of recorded data of several CV clinical variables was calculated. A multivariate analysis was performed to investigate the association between doctors' and patients' characteristics and different patterns in recording. Finally, the completeness in recording was calculated with a score and plotted against three indicators of appropriateness.


RESULTS
The only risk factor that achieved a good standard of registration was blood pressure (89%). Low-density lipoprotein and waist circumference were largely under-recorded, whereas lifestyle data collection was almost negligible. Age, specialization, and use of electronic records increase the accuracy in recording. When one CV risk factor was predominant, the probability of having other risk factors recorded was reduced. A significant increase in the proportion of patients treated according to guidelines was found in doctors who were more accurate in recording.


CONCLUSIONS
A link exists between accuracy in recording with both quality of care and adherence to guidelines. Specific training of all doctors in this field should be considered.
Giorda
Carlo Bruno
CB
Metabolism and Diabetes Unit, ASL Turin 5 and Chaira Medica Association, Chieri (TO), Italy. giordaca@tin.it
Guida
Piero
P
Avogaro
Angelo
A
Cortese
Claudio
C
Mureddu
Gian Francesco
GF
Corsini
Alberto
A
Comaschi
Marco Antonio
MA
Manzato
Enzo
E
Volpe
Massimo
M
Zito
Giovanni Battista
GB
Medea
Gerardo
G
Ventriglia
Giuseppe
G
Titta
Giulio
G
Riccardi
Gabriele
G
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002309:Cardiology / Q000592:standards*; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D005194:Family Practice / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007558:Italy; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference
D015415:Biomarkers; D008055:Lipids