title: Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care.
abstract: BACKGROUND
  Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD), patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio), we have developed and tested a set of standardized measures, linked to previously developed quality indicators.
  
  
  METHODS
  A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk) and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey). Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings.
  
  
  RESULTS
  The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD)-patients--and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries.
  
  
  CONCLUSIONS
  An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare.
authors.affiliation: Department of General Practice and Health Services Research, University of Heidelberg Hospital, Voßstrasse 2, D-69115 Heidelberg, Germany. sabine.ludt@med.uni-heidelberg.de
authors.forename: Sabine
authors.initials: S
authors.lastname: Ludt
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Campbell
authors.forename: Jan
authors.initials: J
authors.lastname: van Lieshout
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
authors.forename: Joachim
authors.initials: J
authors.lastname: Szecsenyi
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003625:Data Collection / Q000295:instrumentation*; D005060:Europe; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000592:standards*; D012307:Risk Factors; D012308:Risk Management / Q000379:methods*; D055815:Young Adult