title: Clinical prediction rules in practice: review of clinical guidelines and survey of GPs.
abstract: BACKGROUND
  The publication of clinical prediction rules (CPRs) studies has risen significantly. It is unclear if this reflects increasing usage of these tools in clinical practice or how this may vary across clinical areas.
  
  
  OBJECTIVE
  To review clinical guidelines in selected areas and survey GPs in order to explore CPR usefulness in the opinion of experts and use at the point of care.
  
  
  METHODS
  A review of clinical guidelines and survey of UK GPs.
  
  
  METHODS
  Clinical guidelines in eight clinical domains with published CPRs were reviewed for recommendations to use CPRs including primary prevention of cardiovascular disease, transient ischaemic attack (TIA) and stroke, diabetes mellitus, fracture risk assessment in osteoporosis, lower limb fractures, breast cancer, depression, and acute infections in childhood. An online survey of 401 UK GPs was also conducted.
  
  
  RESULTS
  Guideline review: Of 7637 records screened by title and/or abstract, 243 clinical guidelines met inclusion criteria. CPRs were most commonly recommended in guidelines regarding primary prevention of cardiovascular disease (67%) and depression (67%). There was little consensus across various clinical guidelines as to which CPR to use preferentially.
  
  
  METHODS
  Of 401 responders to the GP survey, most were aware of and applied named CPRs in the clinical areas of cardiovascular disease and depression. The commonest reasons for using CPRs were to guide management and conform to local policy requirements.
  
  
  CONCLUSIONS
  GPs use CPRs to guide management but also to comply with local policy requirements. Future research could focus on which clinical areas clinicians would most benefit from CPRs and promoting the use of robust, externally validated CPRs.
authors.affiliation: Department of Primary Care Health Sciences, University of Oxford, Oxford.
authors.forename: Annette
authors.initials: A
authors.lastname: Plüddemann
authors.forename: Emma
authors.initials: E
authors.lastname: Wallace
authors.forename: Clare
authors.initials: C
authors.lastname: Bankhead
authors.forename: Claire
authors.initials: C
authors.lastname: Keogh
authors.forename: Danielle
authors.initials: D
authors.lastname: Van der Windt
authors.forename: Daniel
authors.initials: D
authors.lastname: Lasserson
authors.forename: Rose
authors.initials: R
authors.lastname: Galvin
authors.forename: Ivan
authors.initials: I
authors.lastname: Moschetti
authors.forename: Karen
authors.initials: K
authors.lastname: Kearley
authors.forename: Kirsty
authors.initials: K
authors.lastname: O'Brien
authors.forename: Sharon
authors.initials: S
authors.lastname: Sanders
authors.forename: Susan
authors.initials: S
authors.lastname: Mallett
authors.forename: Uriell
authors.initials: U
authors.lastname: Malanda
authors.forename: Matthew
authors.initials: M
authors.lastname: Thompson
authors.forename: Tom
authors.initials: T
authors.lastname: Fahey
authors.forename: Richard
authors.initials: R
authors.lastname: Stevens
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D003661:Decision Support Techniques; D003863:Depression / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D005260:Female; D005264:Femoral Fractures / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D058006:General Practice; D006306:Health Surveys; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D058866:Osteoporotic Fractures / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D020521:Stroke / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D011795:Surveys and Questionnaires; D013978:Tibial Fractures / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D006113:United Kingdom
keywords: clinical guidelines; clinical prediction rules; survey