Intra-rator variability of primary care physicians in management of hyperlipidaemia.

BACKGROUND

Recent studies support the link between hyperlipidaemia and increased prevalence of cardiovascular diseases (CVDs). In Saudi Arabia, CVDs became a serious problem following rapid urbanization. The health care system in Saudi Arabia makes the primary care accessible to all.

AIM

To assess the ability of primary care physicians to be consistent with themselves in the management of hyperlipidaemia.

DESIGN OF THE STUDY

Cross-sectional.

SETTING

Family medicine department affiliated with tertiary hospital.

METHOD

Using 63 patient problem vignettes, each physician was asked, whether a patient required no treatment, dietary or drug treatment. Exact vignette cases were shown again to each physician two weeks later. The Kappa statistical test was used to measure the physician's intra-rator variability.

RESULTS

Forty-seven physicians were recruited to participate in this study. The Kappa statistics suggested an excellent intra-rator agreement by only four physicians, but a large majority, 28 physicians (62.2%) had fair to good agreement while thirteen physicians (28.9%) had poor agreement with themselves.

CONCLUSION

It is suggested that doctors must undergo adequate training and continuous evaluation of their skills in the management of hyperlipidaemia. Use of vignettes, might be a good method in assessing continuous medical education.