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Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn. International Register and Clinical Domains in Primary Care Claire Keogh and the HRB Centre for Primary Care Research . Section 1 Definitions and the need for an international register of CPRs for primary care

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Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

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  1. Royal College of Surgeons in IrelandColáiste Ríoga na Máinleá in Éirinn International Register and Clinical Domains in Primary Care Claire Keogh and the HRB Centre for Primary Care Research

  2. Section 1 • Definitions and the need for an international register of CPRs for primary care • Section 2 • Search strategies to identify CPRs relevant to primary care from the MEDLINE database • Section 3 • The International Register of CPRs for Primary Care • Clinical domains • Ongoing work

  3. Section 1

  4. Definitions • Clinical Prediction Rule • Clinical tools that quantify the contribution of • Patient History • Physical Examination • Diagnostic Tests • Stratify patients diagnosis • Probability of having target disorder. • Outcome can be in terms of diagnosis, prognosis, referral or treatment

  5. Example of a CPR: The Centor Score

  6. Stages of development of CPR

  7. Purpose • Develop a web-based register of CPRs for use in primary care

  8. Problems with developing and maintaining the register • Problems associated with developing and maintaining the register • Interchangeable terminology for CPRs • No Medical Subject Heading (MeSH) term for CPRs • Over two million articles are published every year

  9. Problems with developing and maintaining the register Haynes and the Hedges Team have developed search tools to identify CPRs.

  10. Section 2

  11. 30 journals included on the register

  12. Methods • Manually searched 30 journals relevant to primary care for the year 2008 (‘reference standard’) • 7 individual electronic searches of the 30 journals (each filter treated as ‘diagnostic tests’) • Test accuracy analysis: Sensitivity and specificity • Aim: to maximise sensitivity

  13. Results Manual ‘reference standard’ search retrieved 6344 articles, 41 of which were CPRs

  14. MEDLINE versus the final search filter applied to 30 primary care journals (1966 – 2008) Number of articles in PubMEd Year of publication

  15. SECTION 3

  16. Creating the International Register 2008-1980 resulted in 252 CPRs relevant to primary care * Still awaiting inter-library loans

  17. Clinical Domains – ICPC2Percentage articles retrieved for each clinical domain % %

  18. Clinical Domains – ICPC2Respiratory System

  19. Ongoing Work Register

  20. Summary and Conclusion • Identified the search filter with the highest level of sensitivity to search the MEDLINE database using the PubMed interface • Significant reduction in the items to be searched • Approximately 252 CPRs across several clinical domains (2008-1980). Still awaiting inter-library loans • Further resources are being searched as part of ongoing work

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