title: Validation of heart failure diagnosis registered in primary care records in two primary care centres in Barcelona (Spain) and factors related. A cross-sectional study.
abstract: BACKGROUND
  Heart failure (HF) diagnosis as reported in primary care medical records is not always properly confirmed and could result in over-registration.
  
  
  OBJECTIVE
  To determine the proportion of registered HF that can be confirmed with information from primary care medical records and to analyse related factors.
  
  
  METHODS
  A cross-sectional study. The medical records of 595 HF patients attended in two primary healthcare centres in Barcelona (Spain) were revised and validated by a team of experts who classified diagnosis into confirmed, unconfirmed, and misdiagnosis. Variables potentially related to the confirmation of the diagnosis were analysed. The revision of medical records and data collection took place from 15 January to 31 March 2014.
  
  
  RESULTS
  Mean (standard deviation) age was 78 (10) years and 58% were women. The diagnosis could be confirmed in 53.6% of patients. Factors associated with a greater probability of having a confirmed diagnosis were age (yearly OR: 0.97, 95%CI: 0.95-0.99), cardiologist follow-up (OR: 3.66, 95%CI: 2.46-5.48), history of ischaemic heart disease (OR: 2.18, 95%CI: 1.36-2.48), atrial fibrillation (OR: 2.01, 95%CI: 1.34-3.03), and prescription of loop diuretics (OR: 3.24, 95%CI: 2.14-4.89).
  
  
  CONCLUSIONS
  Only in half of the patients labelled as HF in primary care medical records could this diagnosis be further confirmed. Variables regularly registered in clinical practice could help general practitioners identify those patients requiring a revision of their HF diagnosis.
authors.affiliation: a Centro de Atención Primaria Sant Martí de Provençals , Institut Català de la Salut , Barcelona , Spain.|b Institut d'Investigació en Atenció Primaria IDIAP-Jordi Gol , Barcelona , Spain.|c Departament de Medicina, Facultat de Medicina , Universitat Autónoma de Barcelona , Bellaterra , Spain.|d Programa Integrado de Atención a la Insuficiencia Cardiaca del Área Integral de Salud Barcelona Litoral Mar , Servei Català de la Salut , Barcelona , Spain.
authors.forename: Jose María
authors.initials: JM
authors.lastname: Verdú-Rotellar
authors.affiliation: b Institut d'Investigació en Atenció Primaria IDIAP-Jordi Gol , Barcelona , Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Frigola-Capell
authors.affiliation: b Institut d'Investigació en Atenció Primaria IDIAP-Jordi Gol , Barcelona , Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Alvarez-Pérez
authors.affiliation: b Institut d'Investigació en Atenció Primaria IDIAP-Jordi Gol , Barcelona , Spain.
authors.forename: Daniela
authors.initials: D
authors.lastname: da Silva
authors.affiliation: d Programa Integrado de Atención a la Insuficiencia Cardiaca del Área Integral de Salud Barcelona Litoral Mar , Servei Català de la Salut , Barcelona , Spain.|e Parc de Salut MAR, Servicio de Cardiologıa , Hospital del Mar , Barcelona , Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Enjuanes
authors.affiliation: f Centro de Atención Primaria Sant Roc , Institut Català de la Salut , Badalona , Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Domingo
authors.affiliation: g Centro de Atención Primaria Congres , Institut Català de la Salut , Barcelona , Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Mena
authors.affiliation: b Institut d'Investigació en Atenció Primaria IDIAP-Jordi Gol , Barcelona , Spain.|h Departament de Obstericia, Ginecologia i Medicina Preventiva, Facultat de Medicina , Universidad Autónoma de Barcelona , Bellaterra , Spain.
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Muñoz
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications; D002309:Cardiology; D003430:Cross-Sectional Studies; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008485:Medical Audit; D017202:Myocardial Ischemia / Q000150:complications; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D012307:Risk Factors; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use; D013030:Spain
chemical_list: D049994:Sodium Potassium Chloride Symporter Inhibitors
keywords: Heart failure; accuracy of diagnosis; primary health care