Table 2.
Standardised data collection form used to extract data from individual patient records
| Data collection question | Answer |
| What is your name? (Name of person extracting data) | |
| Date of data extraction (MM-DD-YYYY) | |
| Write the clinic name | |
| Is this a duplicate extraction? | |
| If it is a duplicate extraction, enter the number you and your extraction partner have assigned to this file. | |
| Date of birth (MM-DD-YYYY) | |
| Sex (M/F) | |
| Smoking status (Y/M) | |
| Diagnosis of hypertension (Y/N) | |
| Date of hypertension diagnosis (MM-DD-YYYY) | |
| Can you find one or more blood pressure readings? (Y/N) | |
| Most recent systolic blood pressure | |
| Most recent diastolic blood pressure | |
| Date of the most recent blood pressure measurement (MM-DD-YYYY) | |
| Can you find a second most recent blood pressure reading? (Y/N) | |
| Second most recent systolic blood pressure | |
| Second most recent diastolic blood pressure | |
| Date of the second most recent systolic blood pressure (MM-DD-YYYY) | |
| Diagnosis of diabetes (type 1, type 2, no) | |
| Can you find one or more glycated haemoglobin (HbA1c) measurements? (Y/N) | |
| Most recent HbA1c reading (mmol/mol) | |
| Date of the most recent HbA1c measurement? (MM-DD-YYYY) | |
| Can you find another HbA1c measurement? (Y/N) | |
| Second most recent HbA1c reading (mmol/mol, otherwise specify unit) | |
| Date of the second most recent HbA1c reading? (MM-DD-YYYY) | |
| Can you find one or more total cholesterol measurements? (Y/N) | |
| Most recent total cholesterol reading (mmol/L) | |
| Date of the most recent cholesterol reading (MM-DD-YYYY) | |
| Can you find another cholesterol measurement? (Y/N) | |
| Second most recent cholesterol reading (mmol/L) | |
| Date of the second most recent cholesterol reading (MM-DD-YYYY) | |
| Was the patient prescribed a statin? (Y/N) | |
| What was the date of the statin prescription? (MM-DD-YYYY) | |
| What was the drug and dose? | |
| Does the patient have existing cardiovascular disease (CVD)? (Y/N) | |
| State the type of CVD | |
| Has the patient been prescribed acetylsalicylic acid (ASA or aspirin)? (Y/N) | |
| What was the most recent date that ASA was prescribed? (MM-DD-YYYY) | |
| Has the patient been prescribed antihypertensives? (Y/N) | |
| What was the most recent date that antihypertensives were prescribed? (MM-DD-YYYY) | |
| Can you find a documented ESC SCORE risk score? (Y/N) | |
| Enter the most recent documented ESC SCORE risk score (%) | |
| What was the date the risk score was documented? (MM-DD-YYYY) | |
| Please record any important notes about the data extraction here. Examples include an error you think may have been made, clarification of the units for measurements (eg, mmol/L vs mg/dL). Or notes that you would like for yourself. |
ESC, European Society of Cardiology.