ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2016
Overdiagnosis of heart failure in primary care: a cross-sectional study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 56 citations in OpenAlex.
- Long-term outcomes and impact of diagnostic coding of patients with heart failure identified in primary care: insights from the OSCAR-HF cohort.Open heart · 2026Article
- The impact of misdiagnosed heart failure and cardiac or extra-cardiac disease burden on the prognosis in patients with type 2 diabetes.BMC cardiovascular disorders · 2026Observational
- Deep learning algorithm for detection of acute heart failure using standard ECG waveforms.European heart journal. Digital health · 2026Article
- Detection of heart failure in a general population not aware of having the disease.Scandinavian journal of primary health care · 2025Article
- Action on elevated natriuretic peptide in primary care: a retrospective cohort study.BJGP open · 2025Article
- Demystifying heart failure with a preserved ejection fraction: what you need to know.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Misdiagnosis of Chronic Heart Failure in Patients with Type 2 Diabetes Mellitus in Primary Care: A Report of Two Cases and Literature Review.Vascular health and risk management · 2024Review
- Mixed-methods evaluation of a multifaceted heart failure intervention in general practice: the OSCAR-HF pilot study.ESC heart failure · 2023Observational
- Characteristics and management of very elderly patients with heart failure: a retrospective, population cohort study.ESC heart failure · 2023Article
- From Primary to Tertiary Care: Expert Position Statements to Guide Heart Failure with Preserved Ejection Fraction Diagnosis.The Malaysian journal of medical sciences : MJMS · 2023Review
- Performance of the SCORE and Globorisk cardiovascular risk prediction models: a prospective cohort study in Dutch general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Improving Fairness in the Prediction of Heart Failure Length of Stay and Mortality by Integrating Social Determinants of Health.Circulation. Heart failure · 2022Article
- Risk of heart failure among colon and rectal cancer survivors: a population-based case-control study.ESC heart failure · 2022Article
- Heart failure with preserved, mid-range, and reduced ejection fraction across health care settings: an observational study.ESC heart failure · 2022Observational
- Machine learning optimization of an electronic health record audit for heart failure in primary care.ESC heart failure · 2022Observational
- Determinants of exercise intolerance symptoms considered non-specific for heart failure in patients with stage A and B: role of the left atrium in the transition phase to overt heart failure.The international journal of cardiovascular imaging · 2022Article
- Persistent Symptoms and Health Needs of Women and Men With Non-Obstructed Coronary Arteries in the Years Following Coronary Angiography.Frontiers in cardiovascular medicine · 2021Article
- Precipitating factors of heart failure decompensation, short-term morbidity and mortality in patients attended in primary care.Scandinavian journal of primary health care · 2020Article
- Training general practitioners to improve evidence-based drug treatment of patients with heart failure: a cluster randomised controlled trial.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020Article
- Time trends in the use and appropriateness of natriuretic peptide testing in primary care: an observational study.BJGP open · 2020Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccess to echocardiography in primary care is limited, but is necessary to accurately diagnose heart failure (HF).
aimTo determine the proportion of patients with a GP's diagnosis of HF who really have HF. DESIGN AND
settingA cross-sectional study of patients in 30 general practices with a GP's diagnosis of heart failure, based on the International Classification of Primary Care (ICPC) code K77, between June and November 2011.
methodElectronic medical records of the patients' GPs were scrutinised for information on the diagnosis. An expert panel consisting of two cardiologists and an experienced GP used all available diagnostic information, and established the presence or absence of HF according to the criteria of the European Society of Cardiology (ESC) HF guidelines.
resultsIn total, 683 individuals had a GP's diagnosis of HF. The mean age was 77.9 (SD 11.4) years, and 42.2% were male. Of these 683, 79.6% received cooperative care from a cardiologist. In 73.5% of cases, echocardiography was available for panel re-evaluation. Based on consensus opinion of the panel, 434 patients (63.5%, 95% confidence interval [CI] = 59.9 to 67.1) had definite HF, of which 222 (32.5%, 95% CI = 30.9 to 34.1) had HF with a reduced ejection fraction (HFrEF), 207 (30.3%, 95% CI = 29.0 to 31.6) had HF with a preserved ejection fraction (HFpEF), and five (0.7%, 95% CI = 1.2 to 2.6) had isolated right-sided HF. In 17.3% of cases (95% CI = 14.4 to 20.0), the panel considered HF absent, and in 19.2% (95% CI = 16.3 to 22.2) the diagnosis remained uncertain.
conclusionMore than one-third of primary care patients labelled with HF may not have HF, and such overdiagnosis may result in inadequate patient management.
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