Computer decision support systems for opportunistic health screening and for chronic heart failure management in primary health care

..................................................................................................... 3 List of publications .................................................................................... 4 List of abbreviations .................................................................................. 6 Introduction ................................................................................................ 7 PHC in Sweden .................................................................................... 7 EPR systems ......................................................................................... 7 Screening and prevention ..................................................................... 8 Management of chronic diseases ....................................................... 10 Computer decision support systems .................................................. 11 Exploring the use of CDSSs in clinical practice ............................... 13 Aims ......................................................................................................... 14 General aim ........................................................................................ 14 Specific aims ...................................................................................... 14 Materials ................................................................................................... 15 The EPR systems ................................................................................ 15 The CDSSs ......................................................................................... 17 Setting and subjects ............................................................................ 18 Methods .................................................................................................... 20 Study I ................................................................................................. 20 Study II ............................................................................................... 22 Study III .............................................................................................. 23 Study IV .............................................................................................. 23 Analysis .............................................................................................. 25 Ethical approval .................................................................................. 26 Results ...................................................................................................... 27 Study I ................................................................................................. 27 Study II ............................................................................................... 27 Study III .............................................................................................. 29 Study IV .............................................................................................. 33 Discussion ................................................................................................ 41 The CDSSs ......................................................................................... 41 The EPR systems ................................................................................ 44 The use and effect of the CDSSs ....................................................... 45 Screening and prevention ................................................................... 47 The management of chronic diseases ................................................ 48 PHC .................................................................................................... 49 Conclusions .............................................................................................. 52 Forthcoming research .............................................................................. 53 Apendix .................................................................................................... 54 Acknowledgements .................................................................................. 55 Summary in Swedish – Sammanfattning på svenska ............................. 56 References ................................................................................................ 59 Publications .............................................................................................. 71