The aim of this study was to design, develop and test an expert system to help professionals in clinical decision-making as providing an assessment of the health of workers at very high CVR.Design and method:
It was designed and developed an operational web expert system in ASP language, which gathers information on risk factors and returns an output with recommendations for management of risk factors based on the 2012 criteria of the European Guidelines on Cardiovascular Disease Prevention. In the case of needing an intervention or modification of drug treatment, the expert system helps to plan them. The CVR was stratified by the European SCORE system for low-risk countries. A test was conducted with a pilot program providing workers with very high CVR (SCORE >=10). The adherence to the Mediterranean diet was assessed by a 14-item questionnaire and physical activity by the International Physical Activity Questionnaire (IPAQ).Results:
This pilot study included 11 patients with a mean age of 63.2 years (± 4.2). All the participants were men, 71.7% and 45.5% had hypertension and dyslipidaemia, but only 36.4% and 18.2% of them were receiving anti-hypertensive treatment and lipid-lowering therapy at baseline, respectively. These patients, mostly manual workers (63.6%), showed a high level of adherence to the Mediterranean diet in 27.3% of the cases, and moderate over the remaining 72.7%. 81.8% knew they had cardiovascular risk factors. 45.5% were smokers, of which 66.6% expressed their intention to give up smoking in the coming months. The mean BMI was 28.1 kg/m2 and the mean waist circumference was 99.36 cm. A 36.4% of the workers reported being physically very active in the 7 days prior to the follow-up assessment (36.4% sufficiently active and 27.2% insufficiently active).Conclusions:
Our preliminary results suggest that there is a high potential for improvement in lifestyle and CVR control among patients at very high cardiovascular risk. The availability of an expert system could facilitate decision-making when providing medical advice. An expert system could be a value-added service in order to standardize health care and to promote the best clinical practice.