Zero end-digit preference in recorded blood pressure and its impact on classification of patients for pharmacologic management in primary care

Show simple item record Broad, Joanna en Wells, Linda en Marshall, Roger en Jackson, Rodney en 2012-01-03T19:49:34Z en 2007 en
dc.identifier.citation British Journal of General Practice 57(544):897-903 2007 en
dc.identifier.issn 0960-1643 en
dc.identifier.uri en
dc.description.abstract Aim: To document the use of rounding to zero end-digit and assess its potential impact on eligibility for pharmacologic management of CVD risk. Design of study: Cross-sectional study. Setting: A total of 23 676 patients having opportunistic CVD risk assessment in primary care practices in New Zealand. Method: To simulate rounding in practice, for patients with systolic blood pressures recorded without a zero end-digit, a second blood pressure measure was generated by arithmetically rounding to the nearest zero end-digit. A 10-year Framingham CVD risk score was estimated using actual and rounded blood pressures. Eligibility for pharmacologic treatment was then determined using the Joint British Societies' JBS2 and the British Hypertension Society BHS-IV guidelines based on actual and rounded blood pressure values. Results: Zero end-digits were recorded in 64% of systolic and 62% of diastolic blood pressures. When eligibility for drug treatment was based only on a Framingham 10year CVD risk threshold of 20% or more, rounding misclassified one in 41 of all those patients subject to this error. Under the two guidelines which use different combinations of CVD risk and blood pressure thresholds, one in 19 would be misclassified under JBS2 and one in 12 under the BHS-IV guidelines mostly towards increased treatment. Conclusion: Zero end-digit preference significantly increases a patient's likelihood of being classified as eligible for drug treatment. Guidelines that base treatment decisions primarily on absolute CVD risk are less susceptible to these errors. en
dc.publisher Royal College of General Practitioners en
dc.relation.ispartofseries British Journal of General Practice en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from en
dc.rights.uri en
dc.title Zero end-digit preference in recorded blood pressure and its impact on classification of patients for pharmacologic management in primary care en
dc.type Journal Article en
dc.identifier.doi 10.3399/096016407782317964 en
pubs.issue 544 en
pubs.begin-page 897 en
pubs.volume 57 en
dc.rights.holder Copyright: Royal College of General Practitioners en
dc.identifier.pmid 17976291 en
pubs.end-page 903 en
dc.rights.accessrights en
pubs.subtype Article en
pubs.elements-id 72773 en Medical and Health Sciences en Population Health en Epidemiology & Biostatistics en School of Medicine en Medicine Department en
pubs.record-created-at-source-date 2010-09-01 en
pubs.dimensions-id 17976291 en

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