Hypercholesterolaemia: setting a Dutch national standard.

Since 1989 the Dutch college of general practitioners (Nederlands Huisartsen Genootschap) has published a total of 22 standards on different subjects. For the standard on hypercholesterolaemia a working conference was organized and attended by the most active general practitioners in the college. The conference aimed to facilitate the publication of a well balanced standard and to judge the value of the previously used procedure in which the draft standard was sent to a sample of college members for their comments on the feasibility of the guidelines. Six controversial areas of hypercholesterolaemia were discussed at the conference and the conclusions reached were compared with the opinions of the random sample responding to the postal questionnaire. The representativeness of the populations consulted and the impact of the conference on the standard were also studied. Compared with the total population of Dutch general practitioners, women and those in the youngest age group (30-35 years) were over-represented in the random sample, while at the conference general practitioners from two partner and group practices were over-represented. There were no significant differences in background characteristics between the 36 conference participants and the 52 respondents to the written inquiry. Their opinions differed on the appropriateness of an upper age limit for screening for hypercholesterolaemia and on whether the 'average' general practitioner can prescribe a cholesterol-lowering diet. The results of the conference appear to have altered the final text of the standard on four issues: screening in women, having an upper age limit for screening, the time period for blood sampling and the prescription of a cholesterol-lowering diet by the general practitioner.(ABSTRACT TRUNCATED AT 250 WORDS)