title: Is the physician's behavior in dyslipidemia diagnosis in accordance with guidelines? Cross-sectional ESCARVAL study.
abstract: BACKGROUND
  Clinical inertia has been defined as mistakes by the physician in starting or intensifying treatment when indicated. Inertia, therefore, can affect other stages in the healthcare process, like diagnosis. The diagnosis of dyslipidemia requires ≥2 high lipid values, but inappropriate behavior in the diagnosis of dyslipidemia has only previously been analyzed using just total cholesterol (TC).
  
  
  OBJECTIVE
  To determine clinical inertia in the dyslipidemia diagnosis using both TC and high-density lipoprotein cholesterol (HDL-c) and its associated factors.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  All health center visits in the second half of 2010 in the Valencian Community (Spain).
  
  
  METHODS
  11,386 nondyslipidemic individuals aged ≥20 years with ≥2 lipid determinations.
  Gender, atrial fibrillation, hypertension, diabetes, cardiovascular disease, age, and ESCARVAL training course. Lipid groups: normal (TC<5.17 mmol/L and normal HDL-c [≥1.03 mmol/L in men and ≥1.29 mmol/L in women], TC inertia (TC≥5.17 mmol/L and normal HDL-c), HDL-c inertia (TC<5.17 mmol/L and low HDL-c), and combined inertia (TC≥5.17 mmol/L and low HDL-c).
  
  
  RESULTS
  TC inertia: 38.0% (95% CI: 37.2-38.9%); HDL-c inertia: 17.7% (95% CI: 17.0-18.4%); and combined inertia: 9.6% (95% CI: 9.1-10.2%). The profile associated with TC inertia was: female, no cardiovascular risk factors, no cardiovascular disease, middle or advanced age; for HDL-c inertia: female, cardiovascular risk factors and cardiovascular disease; and for combined inertia: female, hypertension and middle age.
  
  
  CONCLUSIONS
  Cross-sectional study, under-reporting, no analysis of some cardiovascular risk factors or other lipid parameters.
  
  
  CONCLUSIONS
  A more proactive attitude should be adopted, focusing on the full diagnosis of dyslipidemia in clinical practice. Special emphasis should be placed on patients with low HDL-c levels and an increased cardiovascular risk.
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Palazón-Bru
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain.
authors.forename: Vicente F
authors.initials: VF
authors.lastname: Gil-Guillén
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain.
authors.forename: Domingo
authors.initials: D
authors.lastname: Orozco-Beltrán
authors.affiliation: Health Surveillance Department, Mutual Society of Castellón, Castellón, Spain; Department of Medicine, Jaume I University, Castellón, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Pallarés-Carratalá
authors.affiliation: Health Center of Benigánim, Generalitat Valenciana, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Valls-Roca
authors.affiliation: Health Center of Algemesí, Generalitat Valenciana, Valencia, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Sanchís-Domenech
authors.affiliation: School of Medicine, University of Valencia, Valencia, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Martín-Moreno
authors.affiliation: School of Medicine, University of Valencia, Valencia, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Redón
authors.affiliation: School of Medicine, University of Valencia, Valencia, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Navarro-Pérez
authors.affiliation: Department of Clinical Medicine, Miguel Hernández University, Alicante, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Giménez
authors.affiliation: Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Generalitat Valenciana, Valencia, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Pérez-Navarro
authors.affiliation: Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain.
authors.forename: José L
authors.initials: JL
authors.lastname: Trillo
authors.affiliation: Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain.
authors.forename: Ruth
authors.initials: R
authors.lastname: Usó
authors.affiliation: Conselleria de Sanitat, Generalitat Valenciana, Valencia, Spain.
authors.forename: Elías
authors.initials: E
authors.lastname: Ruiz
mesh_terms: D000328:Adult; D000368:Aged; D002309:Cardiology / Q000379:methods*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003142:Communication; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D013030:Spain; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D002784:Cholesterol