[Concordance and usefulness of a stratification system for clinical decision making].
OBJECTIVE
1) To analyse concordance between the level of risk classification using the Adjusted Groups Morbidity (GMA) tool and the assigned level of intervention by general practitioners (GP). 2) To study the usefulness of the GMA tool as an aid in electronic medical records (EMR) for decision making.


METHODS
Cross-sectional observational study of concordance.


METHODS
Primary Care. Madrid Health Service.


METHODS
Twenty eight GPs. A sample of 840 patients assigned to participating GPs was selected by disproportionate stratified random sampling (0.65 kappa, 0.125 precision, 5% positive rate, 95% confidence level).


METHODS
Weighted Cohen Kappa index for the degree of concordance between the GMA tool and the GPs. The usefulness of the tool was assessed using an ad hoc developed questionnaire.


RESULTS
Kappa weighted index obtained was 0.60 (95%CI: 0.55-0.65). In 3% of cases the disagreement was maximum. The GPs found that the grouping tool had been useful in 76% of cases.


CONCLUSIONS
Moderate strength/good concordance; incorporating a grouping tool in the EMR helps as a reminder for taking more proactive/integrated decisions based on social and health needs of people with chronic diseases.
Unidad de Apoyo Técnico, Gerencia Adjunta de Planificación y Calidad (GAPYC), Gerencia de Atención Primaria (GAP), REDISSEC, Madrid, España. Electronic address: aisabel.gonzalezg@salud.madrid.org.
Ana Isabel
AI
González González
Coordinación de la Estrategia de Atención a Pacientes con Enfermedades Crónicas en la Comunidad de Madrid, GAPYC, GAP, Madrid, España.
Ana María
AM
Miquel Gómez
Coordinación de la Estrategia de Atención a Pacientes con Enfermedades Crónicas en la Comunidad de Madrid, GAPYC, GAP, Madrid, España.
David
D
Rodríguez Morales
Dirección Técnica de Sistemas de Información, GAPYC, GAP, Madrid, España.
Montserrat
M
Hernández Pascual
Dirección Técnica de Sistemas de Información Sanitaria, GAPYC, GAP, REDISSEC, Madrid, España.
Luis
L
Sánchez Perruca
Dirección Técnica de Procesos y Calidad, GAPYC, GAP, Madrid, España.
Inmaculada
I
Mediavilla Herrera
D000066491:Clinical Decision-Making / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment
Atención primaria; Chronic disease; Clasificación; Classification; Enfermedad crónica; Estratificación; Primary health care; Stratification