Table 2

Standardised data collection form used to extract data from individual patient records

Data collection questionAnswer
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.