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which collects clinical records from a representative sample of the Italian population.
Clinical computerized data from 320 GPs and 221,557 male patients were analysed.
Among total requests for PSA, 3% were linked to prostate cancer, 18% to a urological
disease or symptom and 79% were not linked to any urological condition (opportuni-
stic screening). Opportunistic screening was used for 31.4% of subjects over 50 with
a significant (P<0.0001) difference between geographical areas (36.4% north, 33.5%
central regions, 22.9% south and isles). This distribution was very similar to prostate
cancer prevalence as it resulted from the HS data. PSA testing practice showed an incre-
ase over the years (12.7% of men over 50 in 2000, 14.3% in 2001 and 15.9% in 2002).
In conclusion, the practice of opportunistic screening of prostate cancer seems to be
extensively adopted by Italian GPs and is becoming more and more popular, although
to date it is not supported by strong scientific evidence.
36. Fabiani L, Scatigna M, Panopoulou K, Sabatini A, Sessa E, Donato F, Marchi M, Nardi
R, Niccolai C, Samani F, Ventriglia G. Health Search: istituto di ricerca della societÓ
italiana di medicina generale: la realizzazione di un database per la ricerca in me-
dicina generale
. Epidemiol & Prev. 2004;28:156-162.
ABSTRACT. OBJECTIVE: To describe a database used in general practice by analysing
the characteristics of the physicians providing the data and the completeness of the
data recording on the basis of the indicators of interest (smoking habits, weight, height,
and the prevalence of hypertension). DESIGN: Descriptive study and multiple linear re-
gression analysis of the relationships between structural variables and outcomes. SET-
TING: General practitioners (GPs) belonging to the Italian Society of General Medicine
(SIMG), and enrolled in Health Search (HS). POPULATION: Six hundred and ninety-five
voluntarily enrolled GPs and their patients. PRINCIPAL OUTCOMES: Descriptive statisti-
cs (mean and median values, standard deviation, frequencies) concerning the general
characteristics of the GPs, the ways in which they connect to the network and their use
of the clinical data management software, and epidemiological measures concerning
the prevalence of hypertension among their patients, and the recording of weight,
height and tobacco smoking habits. RESULTS: The geographic distribution of the GPs is
homogeneous: 317 in Northern Italy (12.52 physicians per 10(6) patients), 134 in Cen-
tral Italy (12.30 physicians per 10(6) patients) and 244 in Southern Italy and the Islands
(11.89 physicians per 10(6) patients). Five hundred and ninety-five (85.6%) are males;
their mean age is 46.7 years (SD +/- 3.8); the mean number of patients per physician
is 1128; 69% have at least one post-graduate specialisation; 49% practise alone; and
they work for a mean of 30 hours per week (SD +/- 13). Five hundred and fifty-three
GPs were actually connected to the network as of January 2003. The data relating to
the years 2000-2001 show an increase in the number of connected physicians (34 in
2000 and 261 in 2001) and in the number of connections (a median of 12 in 2000 and
17 in 2001). The GPs contact more than 80% of their patients every year. The frequen-
cy of the recording of data concerning smoking habits, weight and height increases in
proportion with the frequency of connections. The prevalence of hypertension among
the patients included in the survey is 5.4%. Multiple regression analysis showed that
the variability in the prevalence of hypertension was not influenced by the frequency of
PC use but by the different structure of the age classes of the patients. CONCLUSIONS:
This study of the variables relating to GPs, their clinical practices, and their use of com-
puterised records (examined by means of the chosen indicators) shows that the regular
and complete recording of the principal data of health interest is feasible insofar as it is
not biased by the characteristics of the GPs, and advantageous. The construction of the
database therefore represents a first step towards the initiation of routine research into
general practice in Italy.