{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:35:40Z","timestamp":1788561340299,"version":"build-2803163510"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether the addition of a primary aldosteronism (PA) predictive model to a secondary hypertension decision support tool increases screening for PA in a primary care setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>One hundred fifty-three primary care clinics were randomized to receive a secondary hypertension decision support tool with or without an integrated predictive model between August 2023 and April 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For patients with risk scores in the top 1 percentile, 63\/2896 (2.2%) patients where the alert was displayed in model clinics had the order set launched, while 12\/1210 (1.0%) in no-model clinics had the order set launched (P\u2009=\u2009.014). Nineteen of 2896 (0.66%) of these highest risk patients in model clinics had an aldosterone-to-renin ratio (ARR) ordered compared to 0\/1210 (0.0%) patients in no-model clinics (P\u2009=\u2009.010). For patients with scores not in the top 1 percentile, 438\/20 493 (2.1%) patients in model clinics had the order set launched compared to 273\/17 820 (1.5%) in no-model clinics (P\u2009&amp;lt;\u2009.001). One hundred twenty-four of 20 493 (0.61%) in model clinics had an ARR ordered compared to 34\/17 820 (0.19%) in the no-model clinics (P\u2009&amp;lt;\u2009.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The addition of a PA predictive model to secondary hypertension alert displays and triggering criteria along with order set displays and order preselection criteria results in a statistically and clinically significant increase in screening for PA, a condition that clinicians insufficiently screen for currently.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Addition of a predictive model for an under-screened condition to traditional clinical decision support may increase screening for these conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jamiaopen\/ooae123","type":"journal-article","created":{"date-parts":[[2024,10,15]],"date-time":"2024-10-15T15:27:24Z","timestamp":1729006044000},"source":"Crossref","is-referenced-by-count":1,"title":["The impact of a primary aldosteronism predictive model in secondary hypertension decision support"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0627-5334","authenticated-orcid":false,"given":"Peter B","family":"Mack","sequence":"first","affiliation":[{"name":"Institute of Quality and Safety, Novant Health , Winston-Salem, NC 27103,","place":["United States"]},{"name":"Community Health and Wellness Institute, Novant Health , Winston-Salem, NC 27103,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0320-6894","authenticated-orcid":false,"given":"Casey","family":"Cole","sequence":"additional","affiliation":[{"name":"Cognitive Computing, Novant Health , Winston-Salem, NC 27103,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7809-8234","authenticated-orcid":false,"given":"Mintaek","family":"Lee","sequence":"additional","affiliation":[{"name":"Cognitive Computing, Novant Health , Winston-Salem, NC 27103,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5307-0216","authenticated-orcid":false,"given":"Lisa","family":"Peterson","sequence":"additional","affiliation":[{"name":"Cognitive Computing, Novant Health , Winston-Salem, NC 27103,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Lundy","sequence":"additional","affiliation":[{"name":"Cognitive Computing, Novant Health , Winston-Salem, NC 27103,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0342-9051","authenticated-orcid":false,"given":"Karen","family":"Hegarty","sequence":"additional","affiliation":[{"name":"Cognitive Computing, Novant Health , Winston-Salem, NC 27103,","place":["United States"]},{"name":"Institute for Innovation and AI, Novant Health , Winston-Salem, NC 27103,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Cognitive Computing, Novant Health , Winston-Salem, NC 27103,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,10,28]]},"reference":[{"key":"2024102906215189000_ooae123-B1","first-page":"e13","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults","volume":"71","author":"Whelton","year":"2018","journal-title":"Hypertension."},{"key":"2024102906215189000_ooae123-B2","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1093\/eurheartj\/eht534","article-title":"Secondary arterial hypertension: when, who, and how to screen?","volume":"35","author":"Rimoldi","year":"2014","journal-title":"Eur Heart J."},{"key":"2024102906215189000_ooae123-B3","doi-asserted-by":"crossref","first-page":"10","DOI":"10.7326\/M20-0065","article-title":"The unrecognized prevalence of primary aldosteronism: a cross-sectional study","volume":"173","author":"Brown","year":"2020","journal-title":"Ann Intern Med."},{"key":"2024102906215189000_ooae123-B4","volume-title":"Hypertension Prevalence Among Adults Aged 18 and Over: United States, 2017\u20132018. 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