PT  - JOURNAL ARTICLE
AU  - Lakkhina Troeung
AU  - Diane Arnold-Reed
AU  - Wendy Chan She Ping-Delfos
AU  - Gerald F Watts
AU  - Jing Pang
AU  - Marija Lugonja
AU  - Max Bulsara
AU  - David Mortley
AU  - Matthew James
AU  - Tom Brett
TI  - A new electronic screening tool for identifying risk of familial hypercholesterolaemia in general practice
AID  - 10.1136/heartjnl-2015-308824
DP  - 2016 Jun 01
TA  - Heart
PG  - 855--861
VI  - 102
IP  - 11
4099  - http://heart.bmj.com/content/102/11/855.short
4100  - http://heart.bmj.com/content/102/11/855.full
SO  - Heart2016 Jun 01; 102
AB  - Objective To evaluate the performance of a new electronic screening tool (TARB-Ex) in detecting general practice patients at potential risk of familial hypercholesterolaemia (FH).Methods Medical records for all active patients seen between 2012 and 2014 (n=3708) at a large general practice in Perth, Western Australia were retrospectively screened for potential FH risk using TARB-Ex. Electronic extracts of medical records for patients identified with potential FH risk (defined as Dutch Lipid Clinic Network Criteria (DLCNC) score ≥5) through TARB-Ex were reviewed by a general practitioner (GP) and lipid specialist. High-risk patients were recalled for clinical assessment to determine phenotypic FH diagnosis. Performance was evaluated against a manual record review by a GP in the subset of 360 patients with high blood cholesterol (cholesterol ≥7 mmol/L or low-density lipoprotein cholesterol ≥4.0 mmol/L).Results Thirty-two patients with DLCNC score ≥5 were identified through electronic screening compared with 22 through GP manual review. Sensitivity was 95.5% (95% CI 77.2% to 99.9%), specificity was 96.7% (95% CI 94.3% to 98.3%), negative predictive accuracy was 99.7% (95% CI 98.3% to 100%) and positive predictive accuracy was 65.6% (95% CI 46.9% to 8%). Electronic screening was completed in 10 min compared with 60 h for GP manual review. 10 of 32 patients (31%) were considered high risk and recalled for clinical assessment. Six of seven patients (86%) who attended clinical assessment were diagnosed with phenotypic FH on examination.Conclusions TARB-Ex screening is a time-effective and cost-effective method of systematically identifying potential FH risk patients from general practice records for clinical follow-up.