%PDF-1.6
%
1 0 obj
<>
endobj
2 0 obj
<>stream
Thomas A. Willis, Robert West, Bruno Rushforth, Tim Stokes, Liz Glidewell, Paul Carder, Simon Faulkner, Robbie Foy, on behalf of the ASPIRE programme team
Variations in achievement of evidence-based, high-impact quality indicators in general practice: An observational study
www.plosone.org
www.plosone.org
endstream
endobj
3 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 12 0 R/Contents 13 0 R/TrimBox[0 0 612 792]>>
endobj
12 0 obj
[14 0 R 15 0 R 16 0 R 17 0 R 18 0 R 19 0 R 20 0 R 21 0 R 22 0 R 23 0 R 24 0 R 25 0 R 26 0 R 27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R 35 0 R 36 0 R]
endobj
14 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref001)>>
endobj
15 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref002)>>
endobj
16 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref003)>>
endobj
17 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref004)>>
endobj
18 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref005)>>
endobj
19 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref006)>>
endobj
20 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref007)>>
endobj
21 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref008)>>
endobj
22 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref009)>>
endobj
23 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref010)>>
endobj
24 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref011)>>
endobj
25 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref012)>>
endobj
26 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref013)>>
endobj
27 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref014)>>
endobj
28 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref015)>>
endobj
29 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref016)>>
endobj
30 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref017)>>
endobj
31 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref018)>>
endobj
32 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref019)>>
endobj
33 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref020)>>
endobj
34 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref021)>>
endobj
35 0 obj
<>/Border[0 0 0]/A 37 0 R>>
endobj
37 0 obj
<>
endobj
36 0 obj
<>/Border[0 0 0]/A 38 0 R>>
endobj
38 0 obj
<>
endobj
13 0 obj
[39 0 R 40 0 R 41 0 R 42 0 R 43 0 R 44 0 R 45 0 R 46 0 R 47 0 R 48 0 R 49 0 R 50 0 R 51 0 R 52 0 R 53 0 R 54 0 R 55 0 R 56 0 R 57 0 R 58 0 R 59 0 R 60 0 R 61 0 R]
endobj
39 0 obj
<>stream
q
0.45 0.36 0.35 0.01 k
0 w
575.9997 594.1142 m
199.9998 594.1142 l
199.9998 594.6143 l
575.9997 594.6143 l
f*
0.83 0.64 0.02 0 k
554.5701 510.9165 m
559.3323 510.9165 l
h
f*
310.3937 471.9118 m
315.1559 471.9118 l
h
f*
437.5559 419.9244 m
442.2614 419.9244 l
h
f*
203.4142 393.9024 m
208.1764 393.9024 l
h
f*
340.6677 393.9024 m
345.4299 393.9024 l
h
f*
408.1323 380.9197 m
412.8945 380.9197 l
h
f*
417.3165 380.9197 m
422.0787 380.9197 l
h
f*
454.337 328.9323 m
459.0992 328.9323 l
h
f*
303.0236 302.9102 m
307.7858 302.9102 l
h
f*
312.2079 302.9102 m
321.7323 302.9102 l
h
f*
326.211 302.9102 m
335.7354 302.9102 l
h
f*
400.4787 276.9449 m
410.0031 276.9449 l
h
f*
414.4819 276.9449 m
424.0063 276.9449 l
h
f*
366.0661 263.9055 m
375.5906 263.9055 l
h
f*
380.0693 263.9055 m
389.537 263.9055 l
h
f*
253.474 250.9228 m
262.9417 250.9228 l
h
f*
267.4205 250.9228 m
276.9449 250.9228 l
h
f*
281.3669 250.9228 m
290.8913 250.9228 l
h
f*
455.5276 237.9402 m
465.052 237.9402 l
h
f*
469.474 237.9402 m
478.9984 237.9402 l
h
f*
377.5181 211.9181 m
387.0425 211.9181 l
h
f*
0 g
1 j
1 J
9.5 0 0 9.5 200.0125 707.7543 cm
BT
/F0 1 Tf
1 TL
-0.0042 Tc
0 0 Td
(indicator)Tj
3.9446 0 Td
(achievemen)Tj
5.3351 0 Td
(t.)Tj
0.7757 0 Td
(Statistically)Tj
5.1621 0 Td
(significant)Tj
4.607 0 Td
(practice)Tj
3.682 0 Td
(characteristics)Tj
6.5406 0 Td
(were)Tj
2.3632 0 Td
(identified)Tj
4.1594 0 Td
(less)Tj
-36.5697 -1.474 Td
(frequently)Tj
4.5592 0 Td
(in)Tj
0.9847 0 Td
(adjusted)Tj
3.9506 0 Td
(models.)Tj
ET
Q
q
1 j
1 J
0 w
11.4998 0 0 11.4998 200.0125 666.5952 cm
BT
/F2 1 Tf
1 TL
-0.0035 Tc
0 0 Td
(Conclusions)Tj
ET
Q
q
1 j
1 J
0 w
9.5 0 0 9.5 200.0125 649.5874 cm
BT
/F0 1 Tf
1 TL
-0.0042 Tc
0 0 Td
(Despite)Tj
3.5686 0 Td
(various)Tj
3.4016 0 Td
(policy)Tj
2.7451 0 Td
(and)Tj
1.8619 0 Td
(improvement)Tj
5.9438 0 Td
(initiatives,)Tj
4.5533 0 Td
(there)Tj
2.4706 0 Td
(are)Tj
1.6471 0 Td
(enduring)Tj
4.058 0 Td
(inappropriate)Tj
5.9796 0 Td
(varia-)Tj
-36.2296 -1.468 Td
(tions)Tj
2.3035 0 Td
(in)Tj
0.9846 0 Td
(the)Tj
1.5934 0 Td
(delivery)Tj
3.6224 0 Td
(of)Tj
1.0443 0 Td
(evidence-bas)Tj
5.8781 0 Td
(ed)Tj
1.3129 0 Td
(care.)Tj
2.4229 0 Td
(Much)Tj
2.6437 0 Td
(of)Tj
1.0443 0 Td
(this)Tj
1.7605 0 Td
(variation)Tj
3.9505 0 Td
(is)Tj
0.931 0 Td
(not)Tj
1.5934 0 Td
(explained)Tj
4.4399 0 Td
(by)Tj
1.2651 0 Td
(rou-)Tj
-36.7905 -1.474 Td
(tinely)Tj
2.5183 0 Td
(collected)Tj
4.1177 0 Td
(patient)Tj
3.1867 0 Td
(or)Tj
1.0981 0 Td
(practice)Tj
3.676 0 Td
(variables,)Tj
4.4459 0 Td
(and)Tj
1.8679 0 Td
(is)Tj
0.931 0 Td
(likely)Tj
2.4049 0 Td
(to)Tj
1.0503 0 Td
(be)Tj
1.3129 0 Td
(attributable)Tj
5.1083 0 Td
(to)Tj
1.0444 0 Td
(differences)Tj
5.0546 0 Td
(in)Tj
-37.817 -1.474 Td
(clinical)Tj
3.1688 0 Td
(and)Tj
1.8679 0 Td
(organisational)Tj
6.3555 0 Td
(behaviour.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 541.9842 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Introduction)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 524.9763 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(Clinical)Tj
3.3165 0 Td
(and)Tj
1.7291 0 Td
(health)Tj
2.6759 0 Td
(services)Tj
3.3052 0 Td
(research)Tj
3.5546 0 Td
(continually)Tj
4.7225 0 Td
(produces)Tj
3.8834 0 Td
(new)Tj
1.8765 0 Td
(evidence)Tj
3.7077 0 Td
(that)Tj
1.7802 0 Td
(can)Tj
1.627 0 Td
(benefit)Tj
-32.1786 -1.2982 Td
(patients.)Tj
3.5943 0 Td
(However,)Tj
4.0762 0 Td
(this)Tj
1.6724 0 Td
(evidence)Tj
3.7133 0 Td
(does)Tj
2.041 0 Td
(not)Tj
1.5704 0 Td
(reliably)Tj
3.1691 0 Td
(find)Tj
1.8538 0 Td
(its)Tj
1.1452 0 Td
(way)Tj
1.7915 0 Td
(into)Tj
1.8425 0 Td
(everyday)Tj
3.7644 0 Td
(patient)Tj
3.0047 0 Td
(care)Tj
1.8765 0 Td
([)Tj
0.83 0.64 0.02 0 k
(1)Tj
0 g
(].)Tj
-35.1153 -1.2983 Td
(This)Tj
1.9842 0 Td
(gap)Tj
1.6384 0 Td
(between)Tj
3.5263 0 Td
(evidence)Tj
3.7133 0 Td
(and)Tj
1.7292 0 Td
(clinical)Tj
3.0784 0 Td
(practice)Tj
3.3788 0 Td
(is)Tj
0.8448 0 Td
(a)Tj
0.6576 0 Td
(strategically)Tj
4.9436 0 Td
(important)Tj
4.2803 0 Td
(problem)Tj
3.6113 0 Td
(for)Tj
1.389 0 Td
(policy-)Tj
-34.7752 -1.3039 Td
(makers,)Tj
3.3505 0 Td
(healthcare)Tj
4.3313 0 Td
(systems)Tj
3.2995 0 Td
(and)Tj
1.7291 0 Td
(research)Tj
3.5546 0 Td
(funders)Tj
3.2655 0 Td
(because)Tj
3.3222 0 Td
(it)Tj
0.788 0 Td
(limits)Tj
2.4775 0 Td
(the)Tj
1.4683 0 Td
(health,)Tj
2.9027 0 Td
(social)Tj
2.4605 0 Td
(and)Tj
1.7291 0 Td
(eco-)Tj
-34.6788 -1.2983 Td
(nomic)Tj
2.7836 0 Td
(impacts)Tj
3.3391 0 Td
(of)Tj
1.0148 0 Td
(research)Tj
3.5603 0 Td
([)Tj
0.83 0.64 0.02 0 k
(2)Tj
0 g
(].)Tj
-9.5016 -1.2982 Td
(There)Tj
2.5795 0 Td
(are)Tj
1.4513 0 Td
(particular)Tj
4.1102 0 Td
(implementation)Tj
6.6387 0 Td
(challenges)Tj
4.32 0 Td
(specific)Tj
3.1861 0 Td
(to)Tj
1.0261 0 Td
(primary)Tj
3.4583 0 Td
(care)Tj
1.8708 0 Td
(that)Tj
1.7802 0 Td
(are)Tj
1.4456 0 Td
(not)Tj
-33.063 -1.2983 Td
(encountered)Tj
5.244 0 Td
(in)Tj
1.0318 0 Td
(other)Tj
2.3471 0 Td
(settings.)Tj
3.4696 0 Td
(These)Tj
2.5681 0 Td
(include)Tj
3.1862 0 Td
(rising)Tj
2.5001 0 Td
(workloads)Tj
4.354 0 Td
(and)Tj
1.7291 0 Td
(demands)Tj
3.8608 0 Td
(upon)Tj
2.3244 0 Td
(practice:)Tj
-32.6152 -1.3039 Td
(Hobbs)Tj
2.8686 0 Td
(et)Tj
0.9411 0 Td
(al.)Tj
1.1282 0 Td
(have)Tj
2.0579 0 Td
(shown)Tj
2.846 0 Td
(substantial)Tj
4.507 0 Td
(increases)Tj
3.8325 0 Td
(in)Tj
1.0318 0 Td
(both)Tj
2.0636 0 Td
(the)Tj
1.4683 0 Td
(number)Tj
3.4186 0 Td
(and)Tj
1.7291 0 Td
(duration)Tj
3.702 0 Td
(of)Tj
1.0148 0 Td
(practice)Tj
-32.6095 -1.2983 Td
(consultations)Tj
5.5445 0 Td
(in)Tj
1.0375 0 Td
(UK)Tj
1.6327 0 Td
(primary)Tj
3.4526 0 Td
(care)Tj
1.8708 0 Td
(over)Tj
1.9786 0 Td
(the)Tj
1.4683 0 Td
(period)Tj
2.8347 0 Td
(200714)Tj
3.5943 0 Td
([)Tj
0.83 0.64 0.02 0 k
(3)Tj
0 g
(].)Tj
1.5987 0 Td
(This)Tj
1.9842 0 Td
(needs)Tj
2.5059 0 Td
(to)Tj
1.0261 0 Td
(be)Tj
1.1509 0 Td
(considered)Tj
-31.6798 -1.2982 Td
(alongside)Tj
3.9968 0 Td
(the)Tj
1.474 0 Td
(complex)Tj
3.6226 0 Td
(management)Tj
5.4312 0 Td
(of)Tj
1.0148 0 Td
(escalating)Tj
4.1215 0 Td
(numbers)Tj
3.7814 0 Td
(of)Tj
1.0148 0 Td
(ageing)Tj
2.8233 0 Td
(and)Tj
1.7291 0 Td
(multimorbid)Tj
5.3802 0 Td
(patients)Tj
-34.3897 -1.304 Td
([)Tj
0.83 0.64 0.02 0 k
(4)Tj
0 g
(],)Tj
1.5987 0 Td
(and)Tj
1.7291 0 Td
(rising)Tj
2.5001 0 Td
(public)Tj
2.7099 0 Td
(expectations)Tj
5.1874 0 Td
([)Tj
0.83 0.64 0.02 0 k
(5)Tj
0 g
(],)Tj
1.6044 0 Td
(all)Tj
1.1452 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(context)Tj
3.1805 0 Td
(of)Tj
1.0148 0 Td
(limited)Tj
3.0727 0 Td
(practice)Tj
3.3789 0 Td
(organisational)Tj
-29.6275 -1.2982 Td
(capacity)Tj
3.4695 0 Td
(and)Tj
1.7292 0 Td
(continual)Tj
4.0251 0 Td
(reforms)Tj
3.3619 0 Td
(of)Tj
1.0148 0 Td
(general)Tj
3.1294 0 Td
(practices)Tj
3.7417 0 Td
([)Tj
0.83 0.64 0.02 0 k
(6)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.2586 0 Td
(7)Tj
0 g
(].)Tj
-20.534 -1.2983 Td
(These)Tj
2.5681 0 Td
(system)Tj
2.9367 0 Td
(strains)Tj
2.863 0 Td
(are)Tj
1.4456 0 Td
(compounded)Tj
5.5502 0 Td
(by)Tj
1.1793 0 Td
(multiple,)Tj
3.7927 0 Td
(often)Tj
2.2847 0 Td
(competing)Tj
4.49 0 Td
(implementation)Tj
6.6387 0 Td
(priori-)Tj
-34.9452 -1.3039 Td
(ties.)Tj
1.7914 0 Td
(In)Tj
1.1112 0 Td
(2012,)Tj
2.3471 0 Td
(we)Tj
1.3266 0 Td
(identified)Tj
4.0592 0 Td
(107)Tj
1.6497 0 Td
(National)Tj
3.6907 0 Td
(Institute)Tj
3.583 0 Td
(for)Tj
1.3833 0 Td
(Health)Tj
2.9196 0 Td
(and)Tj
1.7292 0 Td
(Care)Tj
2.1146 0 Td
(Excellence)Tj
4.4107 0 Td
(\(NICE\))Tj
3.2088 0 Td
(clini-)Tj
-35.3251 -1.2983 Td
(cal)Tj
1.3209 0 Td
(guidelines)Tj
4.2803 0 Td
(relevant)Tj
3.4185 0 Td
(to)Tj
1.0262 0 Td
(primary)Tj
3.4525 0 Td
(care,)Tj
2.0977 0 Td
(as)Tj
1.0148 0 Td
(well)Tj
1.8255 0 Td
(as)Tj
1.0148 0 Td
(114)Tj
1.6441 0 Td
(specific)Tj
3.1917 0 Td
(quality)Tj
2.9537 0 Td
(indicators.)Tj
4.4504 0 Td
(Together,)Tj
-31.6911 -1.2982 Td
(these)Tj
2.2506 0 Td
(yielded)Tj
3.0955 0 Td
(a)Tj
0.6519 0 Td
(total)Tj
2.0013 0 Td
(of)Tj
1.0148 0 Td
(2365)Tj
2.1259 0 Td
(clinical)Tj
3.0728 0 Td
(practice)Tj
3.3789 0 Td
(recommendations)Tj
7.5004 0 Td
([)Tj
0.83 0.64 0.02 0 k
(8)Tj
0 g
(].)Tj
1.6044 0 Td
(Several)Tj
3.0444 0 Td
(recent)Tj
2.7099 0 Td
(studies)Tj
2.9877 0 Td
(have)Tj
-35.4385 -1.2983 Td
(identified)Tj
4.0591 0 Td
(the)Tj
1.4684 0 Td
(problems)Tj
3.9741 0 Td
(that)Tj
1.7745 0 Td
(may)Tj
1.9332 0 Td
(arise)Tj
2.075 0 Td
(when)Tj
2.4037 0 Td
(attempting)Tj
4.5921 0 Td
(to)Tj
1.0205 0 Td
(apply)Tj
2.3924 0 Td
(guidelines)Tj
4.2746 0 Td
(to)Tj
1.0262 0 Td
(patients)Tj
3.3675 0 Td
(with)Tj
-34.3613 -1.3039 Td
(multiple)Tj
3.5659 0 Td
(morbidities)Tj
4.8359 0 Td
([e.g.)Tj
0.83 0.64 0.02 0 k
1.8992 0 Td
(9)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
0.9184 0 Td
(10)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.4003 0 Td
(11)Tj
0 g
(].)Tj
1.7348 0 Td
(These)Tj
2.5682 0 Td
(contextual)Tj
4.3937 0 Td
(factors)Tj
2.9026 0 Td
(go)Tj
1.1906 0 Td
(some)Tj
2.33 0 Td
(way)Tj
1.7915 0 Td
(towards)Tj
3.4072 0 Td
(explaining)Tj
-32.9383 -1.2983 Td
(the)Tj
1.4683 0 Td
(well-documented)Tj
7.1999 0 Td
(variations)Tj
4.1613 0 Td
(in)Tj
1.0374 0 Td
(the)Tj
1.4684 0 Td
(delivery)Tj
3.3902 0 Td
(of)Tj
1.0148 0 Td
(primary)Tj
3.4526 0 Td
(care)Tj
1.8708 0 Td
(that)Tj
1.7802 0 Td
(are)Tj
1.4513 0 Td
(consistently)Tj
4.9549 0 Td
(observed)Tj
-33.2501 -1.2982 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(United)Tj
3.0217 0 Td
(Kingdom)Tj
4.0251 0 Td
(\(UK\))Tj
2.3131 0 Td
(and)Tj
1.7291 0 Td
(internationally)Tj
6.1115 0 Td
([)Tj
0.83 0.64 0.02 0 k
(12)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7404 0 Td
(13)Tj
0 g
(].)Tj
1.7348 0 Td
(In)Tj
1.1112 0 Td
(England,)Tj
3.7814 0 Td
(there)Tj
2.2677 0 Td
(is)Tj
0.8447 0 Td
(evidence)Tj
3.7134 0 Td
(that)Tj
-34.8999 -1.304 Td
(the)Tj
1.4683 0 Td
(overall)Tj
2.9026 0 Td
(standard)Tj
3.7247 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8709 0 Td
(is)Tj
0.8504 0 Td
(improving)Tj
4.4333 0 Td
([)Tj
0.83 0.64 0.02 0 k
(14)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7405 0 Td
(15)Tj
0 g
(])Tj
1.508 0 Td
(but)Tj
1.5534 0 Td
(the)Tj
1.4683 0 Td
(variation)Tj
3.8041 0 Td
(between)Tj
3.5263 0 Td
(general)Tj
3.1351 0 Td
(practices)Tj
-33.0007 -1.2982 Td
(remains)Tj
3.4412 0 Td
([e.g.)Tj
0.83 0.64 0.02 0 k
1.9049 0 Td
(16)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.3946 0 Td
(17)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.3946 0 Td
(18)Tj
0 g
(].)Tj
-6.9391 -1.2983 Td
(`Big)Tj
1.7574 0 Td
(data')Tj
2.1317 0 Td
(offers)Tj
2.4604 0 Td
(considerable)Tj
5.2554 0 Td
(promise)Tj
3.4923 0 Td
(in)Tj
1.0318 0 Td
(healthcare)Tj
4.3313 0 Td
(research)Tj
3.5546 0 Td
([)Tj
0.83 0.64 0.02 0 k
(19)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7348 0 Td
(20)Tj
0 g
(].)Tj
1.7405 0 Td
(One)Tj
1.9389 0 Td
(potential)Tj
3.7587 0 Td
(oppor-)Tj
-34.384 -1.3039 Td
(tunity)Tj
2.6135 0 Td
(is)Tj
0.8504 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(measurement)Tj
5.6692 0 Td
(of)Tj
1.0148 0 Td
(quality)Tj
2.9537 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8709 0 Td
(delivered)Tj
3.8891 0 Td
(across)Tj
2.6759 0 Td
(populations.)Tj
5.176 0 Td
(A)Tj
0.9071 0 Td
(prime)Tj
2.6135 0 Td
(example)Tj
-33.7547 -1.2983 Td
(is)Tj
0.8447 0 Td
(the)Tj
1.4683 0 Td
(NHS)Tj
2.1997 0 Td
(Atlas)Tj
2.245 0 Td
(of)Tj
1.0091 0 Td
(Variation)Tj
4.0422 0 Td
(in)Tj
1.0375 0 Td
(Healthcare)Tj
4.5694 0 Td
([)Tj
0.83 0.64 0.02 0 k
(21)Tj
0 g
(],)Tj
2.075 0 Td
(which)Tj
2.6475 0 Td
(illustrates)Tj
4.0535 0 Td
(large)Tj
2.16 0 Td
(geographical)Tj
5.3008 0 Td
(variations)Tj
-33.6527 -1.2982 Td
(across)Tj
2.6758 0 Td
(England)Tj
3.5603 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(level)Tj
2.0126 0 Td
(and)Tj
1.7292 0 Td
(quality)Tj
2.9593 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8709 0 Td
(in)Tj
1.0374 0 Td
(several)Tj
2.931 0 Td
(clinical)Tj
3.0784 0 Td
(areas,)Tj
2.4662 0 Td
(including)Tj
4.0421 0 Td
(diabetes,)Tj
-31.8838 -1.304 Td
(stroke)Tj
2.6758 0 Td
(and)Tj
1.7292 0 Td
(cancer.)Tj
3.0727 0 Td
(The)Tj
1.7801 0 Td
(magnitude)Tj
4.5354 0 Td
(of)Tj
1.0148 0 Td
(these)Tj
2.2507 0 Td
(differences)Tj
4.5638 0 Td
(cannot)Tj
2.982 0 Td
(be)Tj
1.1509 0 Td
(easily)Tj
2.4037 0 Td
(explained)Tj
4.0762 0 Td
(by)Tj
1.1792 0 Td
(popula-)Tj
-33.4145 -1.2982 Td
(tion)Tj
1.8425 0 Td
(and)Tj
1.7291 0 Td
(casemix)Tj
3.4129 0 Td
(factors.)Tj
3.1294 0 Td
(Indeed,)Tj
3.2371 0 Td
(the)Tj
1.4684 0 Td
(Foreword)Tj
4.1385 0 Td
(to)Tj
1.0262 0 Td
(the)Tj
1.4683 0 Td
(Atlas)Tj
2.245 0 Td
(notes)Tj
2.3584 0 Td
(that)Tj
1.7745 0 Td
(the)Tj
1.474 0 Td
(variation)Tj
3.7984 0 Td
(caused)Tj
2.9197 0 Td
(by)Tj
-36.0224 -1.2983 Td
(the)Tj
1.8595 0 Td
(idiosyncratic)Tj
5.3744 0 Td
(practices)Tj
3.7361 0 Td
(of)Tj
1.0148 0 Td
(clinicians)Tj
4.0081 0 Td
(and)Tj
1.7291 0 Td
(of)Tj
1.0148 0 Td
(healthcare)Tj
4.3314 0 Td
(organisations)Tj
5.981 0 Td
(represents)Tj
4.32 0 Td
(unwar-)Tj
-33.3692 -1.2982 Td
(ranted)Tj
2.8232 0 Td
(variation)Tj
3.7984 0 Td
(\(p.15\).)Tj
2.8233 0 Td
(Variation)Tj
4.0422 0 Td
(per)Tj
1.5307 0 Td
(se)Tj
1.0035 0 Td
(is)Tj
0.8504 0 Td
(not)Tj
1.5703 0 Td
(necessarily)Tj
4.5354 0 Td
(inappropriate;)Tj
5.9187 0 Td
(however,)Tj
3.8381 0 Td
(the)Tj
1.4684 0 Td
(varia-)Tj
-34.2026 -1.304 Td
(tion)Tj
1.8425 0 Td
(examined)Tj
4.1272 0 Td
(here)Tj
1.9672 0 Td
(is)Tj
0.8447 0 Td
(considered)Tj
4.6035 0 Td
(`inappropriate')Tj
6.1341 0 Td
(as)Tj
1.0148 0 Td
(it)Tj
0.7824 0 Td
(means)Tj
2.8062 0 Td
(that)Tj
1.7802 0 Td
(many)Tj
2.4774 0 Td
(patients)Tj
3.3676 0 Td
(are)Tj
1.4513 0 Td
(generally)Tj
-33.1991 -1.2982 Td
(not)Tj
1.5703 0 Td
(receiving)Tj
3.8665 0 Td
(recommended)Tj
6.0377 0 Td
(care.)Tj
2.0976 0 Td
(This)Tj
1.9843 0 Td
(is)Tj
0.8504 0 Td
(distinct)Tj
3.2088 0 Td
(from)Tj
2.2053 0 Td
(variation)Tj
3.8041 0 Td
(in)Tj
1.0375 0 Td
(care)Tj
1.8708 0 Td
(where)Tj
2.6476 0 Td
(there)Tj
2.2677 0 Td
(is)Tj
0.8447 0 Td
(not)Tj
1.576 0 Td
(a)Tj
-35.8693 -1.2983 Td
(recommended)Tj
6.032 0 Td
(standard.)Tj
-4.8358 -1.3039 Td
(Enhanced)Tj
4.2236 0 Td
(delivery)Tj
3.3902 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8708 0 Td
(can)Tj
1.6271 0 Td
(have)Tj
2.0636 0 Td
(substantial)Tj
4.5014 0 Td
(implications.)Tj
5.4028 0 Td
(For)Tj
1.6271 0 Td
(example,)Tj
3.77 0 Td
(it)Tj
0.7881 0 Td
(has)Tj
1.542 0 Td
(been)Tj
2.1203 0 Td
(esti-)Tj
-35.138 -1.2983 Td
(mated)Tj
2.7212 0 Td
(that)Tj
1.7801 0 Td
(in)Tj
1.0375 0 Td
(England)Tj
3.5546 0 Td
(more)Tj
2.3414 0 Td
(than)Tj
2.0296 0 Td
(7000)Tj
2.126 0 Td
(strokes)Tj
3.0387 0 Td
(per)Tj
1.5307 0 Td
(year)Tj
1.9049 0 Td
(could)Tj
2.4491 0 Td
(be)Tj
1.1509 0 Td
(prevented,)Tj
4.4333 0 Td
(and)Tj
1.7292 0 Td
(2100)Tj
2.1259 0 Td
(lives)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 378.2551 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Variations)Tj
4.5779 0 Td
(in)Tj
0.978 0 Td
(achievement)Tj
5.7969 0 Td
(of)Tj
1.0417 0 Td
(indicator)Tj
3.6993 0 Td
(s)Tj
0.7157 0 Td
(in)Tj
0.978 0 Td
(general)Tj
3.4866 0 Td
(practice)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
0.83 0.64 0.02 0 k
81.5811 34.9228 m
237.8835 34.9228 l
h
f*
0 g
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.83 0.64 0.02 0 k
0.4748 0 Td
(https://doi.or)Tj
5.4142 0 Td
(g/10.137)Tj
3.8198 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.01779)Tj
4.089 0 Td
(49)Tj
0 g
2.0906 0 Td
(July)Tj
1.9701 0 Td
(13,)Tj
1.5874 0 Td
(2017)Tj
35.3483 0 Td
(2)Tj
0.7654 0 Td
(/)Tj
0.496 0 Td
(18)Tj
ET
Q
q
0.83 0.64 0.02 0 k
1 j
1 J
0 w
38.4378 641.6504 m
132.7181 641.6504 l
h
f*
0 g
7.9999 0 0 7.9999 36 708.7181 cm
BT
/F8 1 Tf
1 TL
-0.025 Tc
0 0 Td
(associated)Tj
4.1457 0 Td
(documen)Tj
3.4866 0 Td
(ts)Tj
0.9 0 Td
(that)Tj
1.6228 0 Td
(the)Tj
1.3749 0 Td
(data)Tj
1.7858 0 Td
(would)Tj
2.4733 0 Td
(be)Tj
-15.7891 -1.3748 Td
(made)Tj
2.2889 0 Td
(publicly)Tj
3.0615 0 Td
(available.)Tj
3.6071 0 Td
(Consequen)Tj
4.1528 0 Td
(tly,)Tj
1.3181 0 Td
(we)Tj
1.2827 0 Td
(are)Tj
-15.7111 -1.3748 Td
(unable)Tj
2.6787 0 Td
(to)Tj
0.9496 0 Td
(make)Tj
2.2323 0 Td
(the)Tj
1.3748 0 Td
(data)Tj
1.793 0 Td
(set)Tj
1.3181 0 Td
(publicly)Tj
3.0614 0 Td
(available)Tj
3.3804 0 Td
(as)Tj
-16.7883 -1.3748 Td
(doing)Tj
2.3102 0 Td
(so)Tj
1.1126 0 Td
(could)Tj
2.2536 0 Td
(contravene)Tj
4.3087 0 Td
(the)Tj
1.3748 0 Td
(UK)Tj
1.3323 0 Td
(Data)Tj
1.9063 0 Td
(Protection)Tj
-14.5985 -1.3748 Td
(Act.)Tj
1.6441 0 Td
(Interested)Tj
3.926 0 Td
(researchers)Tj
4.5709 0 Td
(may)Tj
1.8142 0 Td
(contact)Tj
2.9409 0 Td
(Stella)Tj
-14.8961 -1.3748 Td
(Johnson,)Tj
3.6567 0 Td
(Researc)Tj
2.9976 0 Td
(h)Tj
0.6945 0 Td
(Manager,)Tj
3.7205 0 Td
(West)Tj
2.1189 0 Td
(Yorkshire)Tj
3.7631 0 Td
(R&D)Tj
-16.9513 -1.3748 Td
(\()Tj
0.83 0.64 0.02 0 k
(stella.johns)Tj
4.4716 0 Td
(on@bradf)Tj
3.6497 0 Td
(ord.nhs.uk)Tj
0 g
(\))Tj
4.4929 0 Td
(to)Tj
0.9496 0 Td
(request)Tj
2.9977 0 Td
(and)Tj
-16.5615 -1.3748 Td
(obtain)Tj
2.5086 0 Td
(relevant)Tj
3.1394 0 Td
(data.)Tj
/F7 1 Tf
-5.648 -2.126 Td
(Funding:)Tj
/F8 1 Tf
3.5716 0 Td
(This)Tj
1.7788 0 Td
(paper)Tj
2.3173 0 Td
(presents)Tj
3.4158 0 Td
(independent)Tj
-11.0835 -1.3749 Td
(research)Tj
3.4157 0 Td
(funded)Tj
2.7922 0 Td
(by)Tj
1.1126 0 Td
(the)Tj
1.3677 0 Td
(National)Tj
3.2386 0 Td
(Institute)Tj
3.2245 0 Td
(for)Tj
1.2614 0 Td
(Health)Tj
-16.4127 -1.3748 Td
(Research)Tj
3.6992 0 Td
(\(NIHR\))Tj
2.8488 0 Td
(under)Tj
2.367 0 Td
(its)Tj
1.0913 0 Td
(Programme)Tj
4.656 0 Td
(Grants)Tj
2.6858 0 Td
(for)Tj
-17.3481 -1.3748 Td
(Applied)Tj
2.9764 0 Td
(Researc)Tj
2.9976 0 Td
(h)Tj
0.6945 0 Td
(scheme)Tj
3.1323 0 Td
(\(RP-PG-1209-)Tj
5.3505 0 Td
(10040\);)Tj
-15.1513 -1.3748 Td
(Principal)Tj
3.4228 0 Td
(Investigato)Tj
4.0607 0 Td
(r:)Tj
0.7512 0 Td
(RF.)Tj
1.4598 0 Td
(The)Tj
1.5874 0 Td
(views)Tj
2.3174 0 Td
(expressed)Tj
3.9969 0 Td
(in)Tj
-17.5962 -1.3748 Td
(this)Tj
1.5661 0 Td
(paper)Tj
2.3173 0 Td
(are)Tj
1.3678 0 Td
(those)Tj
2.2677 0 Td
(of)Tj
0.9425 0 Td
(the)Tj
1.3748 0 Td
(authors)Tj
3.0473 0 Td
(and)Tj
1.5874 0 Td
(not)Tj
-14.4709 -1.3748 Td
(necessaril)Tj
3.6921 0 Td
(y)Tj
0.6449 0 Td
(those)Tj
2.2677 0 Td
(of)Tj
0.9496 0 Td
(the)Tj
1.3678 0 Td
(National)Tj
3.2386 0 Td
(Health)Tj
2.5724 0 Td
(Service)Tj
-14.7331 -1.3748 Td
(\(NHS\),)Tj
2.7567 0 Td
(the)Tj
1.3748 0 Td
(NIHR)Tj
2.2394 0 Td
(or)Tj
0.9992 0 Td
(the)Tj
1.3677 0 Td
(Department)Tj
4.5922 0 Td
(of)Tj
0.9496 0 Td
(Health.)Tj
2.7921 0 Td
(The)Tj
-17.0717 -1.3749 Td
(funders)Tj
3.0472 0 Td
(had)Tj
1.5874 0 Td
(no)Tj
1.1693 0 Td
(role)Tj
1.6087 0 Td
(in)Tj
0.8929 0 Td
(study)Tj
2.2607 0 Td
(design,)Tj
2.8984 0 Td
(data)Tj
1.793 0 Td
(collection)Tj
-15.2576 -1.3748 Td
(and)Tj
1.5874 0 Td
(analysis,)Tj
3.4087 0 Td
(decision)Tj
3.2953 0 Td
(to)Tj
0.9496 0 Td
(publish,)Tj
3.1464 0 Td
(or)Tj
0.9993 0 Td
(preparation)Tj
4.4362 0 Td
(of)Tj
-17.8229 -1.3748 Td
(the)Tj
1.3677 0 Td
(manuscript.)Tj
/F7 1 Tf
-1.3677 -2.126 Td
(Competing)Tj
4.3795 0 Td
(interests)Tj
3.3307 0 Td
(:)Tj
/F8 1 Tf
0.4819 0 Td
(The)Tj
1.5875 0 Td
(authors)Tj
3.0401 0 Td
(have)Tj
1.963 0 Td
(declared)Tj
-14.7827 -1.3748 Td
(that)Tj
1.6228 0 Td
(no)Tj
1.1693 0 Td
(competing)Tj
4.1599 0 Td
(interests)Tj
ET
endstream
endobj
40 0 obj
<>stream
endstream
endobj
41 0 obj
<>stream
endstream
endobj
42 0 obj
<>stream
endstream
endobj
43 0 obj
<>stream
endstream
endobj
44 0 obj
<>stream
endstream
endobj
45 0 obj
<>stream
endstream
endobj
46 0 obj
<>stream
endstream
endobj
47 0 obj
<>stream
endstream
endobj
48 0 obj
<>stream
endstream
endobj
49 0 obj
<>stream
endstream
endobj
50 0 obj
<>stream
endstream
endobj
51 0 obj
<>stream
endstream
endobj
52 0 obj
<>stream
endstream
endobj
53 0 obj
<>stream
endstream
endobj
54 0 obj
<>stream
endstream
endobj
55 0 obj
<>stream
endstream
endobj
56 0 obj
<>stream
endstream
endobj
57 0 obj
<>stream
endstream
endobj
58 0 obj
<>stream
endstream
endobj
59 0 obj
<>stream
endstream
endobj
60 0 obj
<>stream
endstream
endobj
61 0 obj
<>stream
BT
10.3394 -28.9986 Td
(exist.)Tj
ET
Q
endstream
endobj
62 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 63 0 R/Contents 64 0 R/TrimBox[0 0 612 792]>>
endobj
63 0 obj
[65 0 R 66 0 R 67 0 R 68 0 R 69 0 R]
endobj
65 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref022)>>
endobj
66 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref008)>>
endobj
67 0 obj
<>/Border[0 0 0]/A 70 0 R>>
endobj
70 0 obj
<>
endobj
68 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref023)>>
endobj
69 0 obj
<>/Border[0 0 0]/A 71 0 R>>
endobj
71 0 obj
<>
endobj
64 0 obj
[72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R]
endobj
72 0 obj
<>stream
q
0.83 0.64 0.02 0 k
306.3685 693.2976 m
315.8929 693.2976 l
h
f*
363.7417 654.3496 m
368.5039 654.3496 l
h
f*
336.0756 327.4016 m
434.211 327.4016 l
h
f*
302.5701 107.9433 m
312.0378 107.9433 l
h
f*
0 g
1 j
1 J
0 w
10 0 0 10 200.0125 707.4141 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(saved,)Tj
2.6475 0 Td
(with)Tj
1.9956 0 Td
(increased)Tj
3.9968 0 Td
(adherence)Tj
4.3256 0 Td
(to)Tj
1.0262 0 Td
(guidelines)Tj
4.2746 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.474 0 Td
(management)Tj
5.4311 0 Td
(of)Tj
1.0148 0 Td
(atrial)Tj
2.2734 0 Td
(fibrillation)Tj
4.4674 0 Td
(and)Tj
1.7291 0 Td
(use)Tj
-35.9317 -1.3039 Td
(of)Tj
1.0147 0 Td
(recommended)Tj
6.0321 0 Td
(therapy)Tj
3.2485 0 Td
([)Tj
0.83 0.64 0.02 0 k
(22)Tj
0 g
(].)Tj
-9.0991 -1.2982 Td
(Clearly,)Tj
3.2881 0 Td
(quality)Tj
2.9537 0 Td
(improvement)Tj
5.6693 0 Td
(initiatives)Tj
4.1102 0 Td
(cannot)Tj
2.9763 0 Td
(focus)Tj
2.3301 0 Td
(on)Tj
1.2756 0 Td
(all)Tj
1.1452 0 Td
(clinical)Tj
3.0784 0 Td
(practice)Tj
3.3789 0 Td
(recommenda-)Tj
-31.402 -1.2983 Td
(tions)Tj
2.194 0 Td
(at)Tj
0.9467 0 Td
(once;)Tj
2.3414 0 Td
(there)Tj
2.2621 0 Td
(is)Tj
0.839 0 Td
(a)Tj
0.652 0 Td
(need)Tj
2.1373 0 Td
(to)Tj
1.0204 0 Td
(identify)Tj
3.2882 0 Td
(and)Tj
1.7235 0 Td
(prioritise)Tj
3.8664 0 Td
(those)Tj
2.3301 0 Td
(with)Tj
1.9955 0 Td
(the)Tj
1.4627 0 Td
(potential)Tj
3.7531 0 Td
(for)Tj
1.3833 0 Td
(the)Tj
1.4626 0 Td
(most)Tj
2.1997 0 Td
(pos-)Tj
-35.858 -1.2983 Td
(itive)Tj
1.9275 0 Td
(impact)Tj
2.982 0 Td
(for)Tj
1.3833 0 Td
(patients.)Tj
3.5943 0 Td
(In)Tj
1.1112 0 Td
(earlier)Tj
2.7553 0 Td
(work)Tj
2.279 0 Td
([)Tj
0.83 0.64 0.02 0 k
(8)Tj
0 g
(],)Tj
1.6044 0 Td
(we)Tj
1.3266 0 Td
(identified)Tj
4.0592 0 Td
(a)Tj
0.652 0 Td
(set)Tj
1.3039 0 Td
(of)Tj
1.0148 0 Td
(evidence-based)Tj
6.3155 0 Td
(quality)Tj
-32.309 -1.3039 Td
(indicators)Tj
4.2235 0 Td
(\(QIs\))Tj
2.3471 0 Td
(based)Tj
2.4718 0 Td
(on)Tj
1.2756 0 Td
(criteria)Tj
3.0784 0 Td
(including:)Tj
4.269 0 Td
(burden)Tj
3.1237 0 Td
(of)Tj
1.0148 0 Td
(illness)Tj
2.6759 0 Td
(\(e.g.)Tj
1.8992 0 Td
(prevalence,)Tj
4.7111 0 Td
(severity\);)Tj
3.8381 0 Td
(poten-)Tj
-34.9282 -1.2982 Td
(tial)Tj
1.4626 0 Td
(for)Tj
1.389 0 Td
(significant)Tj
4.388 0 Td
(patient)Tj
3.0047 0 Td
(benefit)Tj
2.9764 0 Td
(\(e.g.)Tj
1.8992 0 Td
(longevity,)Tj
4.1102 0 Td
(quality)Tj
2.9593 0 Td
(of)Tj
1.0148 0 Td
(life\);)Tj
2.0069 0 Td
(scope)Tj
2.4548 0 Td
(for)Tj
1.3833 0 Td
(improvement)Tj
5.6693 0 Td
(upon)Tj
-34.7185 -1.2983 Td
(current)Tj
3.1804 0 Td
(levels)Tj
2.3754 0 Td
(of)Tj
1.0148 0 Td
(achievement;)Tj
5.4935 0 Td
(the)Tj
1.4684 0 Td
(extent)Tj
2.6759 0 Td
(to)Tj
1.0261 0 Td
(which)Tj
2.6532 0 Td
(following)Tj
3.9741 0 Td
(a)Tj
0.6577 0 Td
(recommendation)Tj
7.1376 0 Td
(is)Tj
0.8504 0 Td
(directly)Tj
-32.5075 -1.3039 Td
(within)Tj
2.8119 0 Td
(the)Tj
1.4683 0 Td
(control)Tj
3.1238 0 Td
(of)Tj
1.0148 0 Td
(individual)Tj
4.286 0 Td
(practice)Tj
3.3788 0 Td
(teams;)Tj
2.7836 0 Td
(and)Tj
1.7292 0 Td
(the)Tj
1.4683 0 Td
(feasibility)Tj
4.0365 0 Td
(of)Tj
1.0148 0 Td
(measurement)Tj
5.6693 0 Td
(using)Tj
2.3924 0 Td
(rou-)Tj
-35.1777 -1.2983 Td
(tinely)Tj
2.4547 0 Td
(collected)Tj
3.7417 0 Td
(data.)Tj
2.1374 0 Td
(This)Tj
1.9899 0 Td
(work)Tj
2.279 0 Td
(yielded)Tj
3.0897 0 Td
(a)Tj
0.652 0 Td
(set)Tj
1.3039 0 Td
(of)Tj
1.0148 0 Td
(QIs)Tj
1.6668 0 Td
(that)Tj
1.7801 0 Td
(we)Tj
1.3267 0 Td
(termed)Tj
3.084 0 Td
(`high)Tj
2.2337 0 Td
(impact'.)Tj
-27.5582 -1.2983 Td
(We)Tj
1.61 0 Td
(examined)Tj
4.1329 0 Td
(achievement)Tj
5.2611 0 Td
(against)Tj
3.0274 0 Td
(a)Tj
0.6576 0 Td
(set)Tj
1.2983 0 Td
(of)Tj
1.0148 0 Td
(these)Tj
2.2563 0 Td
(QIs)Tj
1.6668 0 Td
(in)Tj
1.0375 0 Td
(a)Tj
0.6519 0 Td
(sample)Tj
3.0217 0 Td
(of)Tj
1.0148 0 Td
(practices)Tj
3.7417 0 Td
(in)Tj
1.0375 0 Td
(a)Tj
0.652 0 Td
(region)Tj
2.8006 0 Td
(of)Tj
-36.0791 -1.3039 Td
(the)Tj
1.4683 0 Td
(UK.)Tj
1.8538 0 Td
(We)Tj
1.6101 0 Td
(aimed)Tj
2.6929 0 Td
(to)Tj
1.0261 0 Td
(examine)Tj
3.6 0 Td
(the)Tj
1.4683 0 Td
(extent)Tj
2.6816 0 Td
(to)Tj
1.0205 0 Td
(which)Tj
2.6532 0 Td
(variations)Tj
4.1612 0 Td
(in)Tj
1.0375 0 Td
(achievement)Tj
5.2611 0 Td
(to)Tj
1.0261 0 Td
(high)Tj
2.0069 0 Td
(impact)Tj
-33.5676 -1.2982 Td
(indicators)Tj
4.2235 0 Td
(can)Tj
1.6271 0 Td
(be)Tj
1.1509 0 Td
(explained)Tj
4.0705 0 Td
(using)Tj
2.3924 0 Td
(routinely)Tj
3.8608 0 Td
(collected)Tj
3.7417 0 Td
(data.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 517.9464 cm
BT
/F2 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Methods)Tj
/F0 1 Tf
0 -1.5023 Td
(Study)Tj
2.7543 0 Td
(design)Tj
3.1229 0 Td
(and)Tj
1.8661 0 Td
(setting)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 482.9102 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(We)Tj
1.6043 0 Td
(conducted)Tj
4.4277 0 Td
(a)Tj
0.652 0 Td
(cross-sectional)Tj
6.1001 0 Td
(analysis)Tj
3.3222 0 Td
(of)Tj
1.0148 0 Td
(achievement)Tj
5.2611 0 Td
(against)Tj
3.0217 0 Td
(selected)Tj
3.3448 0 Td
(clinical)Tj
3.0728 0 Td
(quality)Tj
2.9537 0 Td
(indica-)Tj
-34.7752 -1.2982 Td
(tors)Tj
1.7574 0 Td
(\(QIs\))Tj
2.3471 0 Td
(using)Tj
2.3867 0 Td
(routinely)Tj
3.8665 0 Td
(collected,)Tj
3.9628 0 Td
(electronic)Tj
4.1556 0 Td
(primary)Tj
3.4525 0 Td
(care)Tj
1.8766 0 Td
(data)Tj
1.9105 0 Td
(from)Tj
2.2053 0 Td
(a)Tj
0.6577 0 Td
(sample)Tj
3.0217 0 Td
(of)Tj
1.0148 0 Td
(general)Tj
-32.6152 -1.2983 Td
(practices)Tj
3.736 0 Td
(in)Tj
1.0375 0 Td
(West)Tj
2.2677 0 Td
(Yorkshire,)Tj
4.405 0 Td
(UK.)Tj
1.8538 0 Td
(Our)Tj
1.8652 0 Td
(analysis)Tj
3.3279 0 Td
(included)Tj
3.7133 0 Td
(patient)Tj
3.0047 0 Td
(and)Tj
1.7292 0 Td
(practice)Tj
3.3788 0 Td
(characteristics)Tj
5.9074 0 Td
(to)Tj
-36.2265 -1.3039 Td
(explore)Tj
3.1747 0 Td
(associations)Tj
4.989 0 Td
(with)Tj
1.9956 0 Td
(indicator)Tj
3.8664 0 Td
(achievement.)Tj
5.4878 0 Td
(Data)Tj
2.1203 0 Td
(covered)Tj
3.3506 0 Td
(the)Tj
1.474 0 Td
(period)Tj
2.8346 0 Td
(1)Tj
0.6916 0 Td
(January)Tj
3.3222 0 Td
(2012)Tj
2.1203 0 Td
(to)Tj
1.0262 0 Td
(31)Tj
-36.4533 -1.2983 Td
(March)Tj
2.8686 0 Td
(2013,)Tj
2.3471 0 Td
(and)Tj
1.7291 0 Td
(were)Tj
2.126 0 Td
(extracted)Tj
3.8834 0 Td
(during)Tj
2.9253 0 Td
(April)Tj
2.3074 0 Td
(2014.)Tj
2.3471 0 Td
(The)Tj
1.7858 0 Td
(demographic)Tj
5.5049 0 Td
(characteristics)Tj
5.9017 0 Td
(of)Tj
1.0147 0 Td
(the)Tj
-34.7411 -1.2982 Td
(334)Tj
1.644 0 Td
(general)Tj
3.1351 0 Td
(practices)Tj
3.7361 0 Td
(in)Tj
1.0374 0 Td
(West)Tj
2.2677 0 Td
(Yorkshire)Tj
4.1783 0 Td
(are)Tj
1.4513 0 Td
(broadly)Tj
3.2655 0 Td
(typical)Tj
2.863 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(average)Tj
3.2258 0 Td
(across)Tj
2.6759 0 Td
(England,)Tj
3.7871 0 Td
(with)Tj
-35.7503 -1.2983 Td
(the)Tj
1.4683 0 Td
(exception)Tj
4.0932 0 Td
(of)Tj
1.0148 0 Td
(higher)Tj
2.8006 0 Td
(levels)Tj
2.3754 0 Td
(of)Tj
1.0148 0 Td
(deprivation)Tj
4.8416 0 Td
(\(practice)Tj
3.719 0 Td
(averaged)Tj
3.753 0 Td
(Index)Tj
2.5229 0 Td
(of)Tj
1.0148 0 Td
(Multiple)Tj
3.6396 0 Td
(Deprivation)Tj
-32.258 -1.3039 Td
(\(IMD\))Tj
2.8686 0 Td
(score)Tj
2.3074 0 Td
(29.0)Tj
1.8708 0 Td
(vs)Tj
1.0375 0 Td
(21.8\).)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 358.4692 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Participants)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 341.4614 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(Of)Tj
1.2529 0 Td
(the)Tj
1.4683 0 Td
(334)Tj
1.6497 0 Td
(general)Tj
3.1295 0 Td
(practices)Tj
3.7417 0 Td
(in)Tj
1.0375 0 Td
(West)Tj
2.2677 0 Td
(Yorkshire)Tj
4.1782 0 Td
(at)Tj
0.9524 0 Td
(the)Tj
1.4684 0 Td
(time)Tj
2.0296 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(study,)Tj
2.6135 0 Td
(272)Tj
1.6498 0 Td
(used)Tj
2.0579 0 Td
(the)Tj
1.4684 0 Td
(SystmOne)Tj
-33.4486 -1.2982 Td
(clinical)Tj
3.0727 0 Td
(information)Tj
5.0796 0 Td
(system)Tj
2.9367 0 Td
(\(TPP,)Tj
0.83 0.64 0.02 0 k
2.5172 0 Td
(http://www.tpp-uk.com/)Tj
0 g
(\).)Tj
10.6015 0 Td
(This)Tj
1.9842 0 Td
(system)Tj
2.9424 0 Td
(permits)Tj
3.2768 0 Td
(centralised)Tj
-32.4111 -1.3039 Td
(data)Tj
1.9105 0 Td
(collection.)Tj
4.337 0 Td
(We)Tj
1.61 0 Td
(sampled)Tj
3.549 0 Td
(randomly)Tj
4.1329 0 Td
(from)Tj
2.2053 0 Td
(this)Tj
1.6725 0 Td
(group)Tj
2.6078 0 Td
(and)Tj
1.7291 0 Td
(stratified)Tj
3.7587 0 Td
(according)Tj
4.184 0 Td
(to)Tj
1.0261 0 Td
(the)Tj
1.474 0 Td
(then)Tj
-34.1969 -1.2983 Td
(configured)Tj
4.5694 0 Td
(five)Tj
1.6497 0 Td
(NHS)Tj
2.1997 0 Td
(Primary)Tj
3.4979 0 Td
(Care)Tj
2.1147 0 Td
(Trusts)Tj
2.7495 0 Td
(\(PCTs\).)Tj
3.3222 0 Td
(Assuming)Tj
4.252 0 Td
(a)Tj
0.6519 0 Td
(30%)Tj
1.9276 0 Td
(decline)Tj
3.0841 0 Td
(rate,)Tj
1.9729 0 Td
(we)Tj
1.3266 0 Td
(initially)Tj
-33.3182 -1.2983 Td
(approached)Tj
4.9039 0 Td
(78)Tj
1.1678 0 Td
(practices)Tj
3.7417 0 Td
(using)Tj
2.3868 0 Td
(a)Tj
0.6576 0 Td
(conventional,)Tj
5.6523 0 Td
(`opt)Tj
1.7688 0 Td
(in')Tj
1.2472 0 Td
(approach.)Tj
4.1783 0 Td
(After)Tj
2.2847 0 Td
(receiving)Tj
3.8664 0 Td
(some)Tj
2.3301 0 Td
(declines)Tj
-34.1856 -1.2982 Td
(and)Tj
1.7291 0 Td
(a)Tj
0.6519 0 Td
(small)Tj
2.3301 0 Td
(number)Tj
3.4186 0 Td
(of)Tj
1.0148 0 Td
(acceptances,)Tj
5.1533 0 Td
(we)Tj
1.3266 0 Td
(decided)Tj
3.3449 0 Td
(to)Tj
1.0204 0 Td
(approach)Tj
3.9572 0 Td
(more)Tj
2.3414 0 Td
(practices)Tj
3.736 0 Td
(in)Tj
1.0375 0 Td
(order)Tj
2.4208 0 Td
(to)Tj
1.0261 0 Td
(ensure)Tj
-34.5087 -1.3039 Td
(that)Tj
1.7744 0 Td
(our)Tj
1.6271 0 Td
(target)Tj
2.5115 0 Td
(was)Tj
1.7008 0 Td
(reached.)Tj
3.5773 0 Td
(We)Tj
1.61 0 Td
(therefore)Tj
3.8495 0 Td
(sampled)Tj
3.5489 0 Td
(an)Tj
1.2076 0 Td
(additional)Tj
4.2746 0 Td
(36)Tj
1.1735 0 Td
(practices,)Tj
3.9628 0 Td
(making)Tj
3.2542 0 Td
(114)Tj
1.6441 0 Td
(in)Tj
-35.7163 -1.2983 Td
(total.)Tj
2.228 0 Td
(At)Tj
1.2018 0 Td
(the)Tj
1.4684 0 Td
(same)Tj
2.262 0 Td
(time,)Tj
2.2507 0 Td
(we)Tj
1.3266 0 Td
(were)Tj
2.126 0 Td
(granted)Tj
3.2882 0 Td
(permission)Tj
4.6601 0 Td
(to)Tj
1.0261 0 Td
(change)Tj
3.0444 0 Td
(to)Tj
1.0261 0 Td
(`opt)Tj
1.7689 0 Td
(out')Tj
1.7631 0 Td
(recruitment)Tj
4.9946 0 Td
(to)Tj
-34.435 -1.2983 Td
(reduce)Tj
2.9139 0 Td
(selection)Tj
3.7191 0 Td
(bias)Tj
1.7915 0 Td
(by)Tj
1.1792 0 Td
(facilitating)Tj
4.456 0 Td
(general)Tj
3.1351 0 Td
(practices')Tj
3.9571 0 Td
(agreement)Tj
4.4221 0 Td
(to)Tj
1.0261 0 Td
(share)Tj
2.3414 0 Td
(anonymised)Tj
5.108 0 Td
(patient)Tj
-34.0495 -1.3039 Td
(data.)Tj
2.1373 0 Td
(Ninety)Tj
2.948 0 Td
(three)Tj
2.2677 0 Td
(practices)Tj
3.736 0 Td
(did)Tj
1.5421 0 Td
(not)Tj
1.576 0 Td
(respond)Tj
3.4753 0 Td
(to)Tj
1.0261 0 Td
(the)Tj
1.4683 0 Td
(initial)Tj
2.5512 0 Td
(invitation)Tj
4.1102 0 Td
(and)Tj
1.7291 0 Td
(were)Tj
2.1203 0 Td
(sent)Tj
1.8539 0 Td
(a)Tj
0.6519 0 Td
(second)Tj
3.0161 0 Td
(let-)Tj
-36.2095 -1.2983 Td
(ter)Tj
1.3095 0 Td
(that)Tj
1.7802 0 Td
(explained)Tj
4.0762 0 Td
(that)Tj
1.7745 0 Td
(they)Tj
1.9275 0 Td
(could)Tj
2.4491 0 Td
(opt)Tj
1.5421 0 Td
(out)Tj
1.5533 0 Td
(if)Tj
0.7767 0 Td
(they)Tj
1.9219 0 Td
(did)Tj
1.5477 0 Td
(not)Tj
1.5704 0 Td
(wish)Tj
2.0579 0 Td
(to)Tj
1.0262 0 Td
(share)Tj
2.3414 0 Td
(data.)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 178.0157 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Variables)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 161.0078 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(All)Tj
1.3946 0 Td
(clinical)Tj
3.0784 0 Td
(data)Tj
1.9105 0 Td
(were)Tj
2.126 0 Td
(routinely)Tj
3.8608 0 Td
(recorded)Tj
3.7984 0 Td
(by)Tj
1.1792 0 Td
(practices)Tj
3.7417 0 Td
(and)Tj
1.7291 0 Td
(amenable)Tj
4.0592 0 Td
(to)Tj
1.0205 0 Td
(remote)Tj
3.067 0 Td
(extraction.)Tj
-30.9654 -1.2982 Td
(Many)Tj
2.5511 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(variables)Tj
3.7191 0 Td
(were)Tj
2.1203 0 Td
(linked)Tj
2.7326 0 Td
(to)Tj
1.0204 0 Td
(conditions)Tj
4.4787 0 Td
(included)Tj
3.7134 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(UK)Tj
1.6271 0 Td
(Quality)Tj
3.1975 0 Td
(and)Tj
1.7291 0 Td
(Outcomes)Tj
-31.8782 -1.3039 Td
(Framework)Tj
4.8528 0 Td
(\(QOF\))Tj
2.9197 0 Td
(year)Tj
1.9049 0 Td
(2012/13.)Tj
3.6283 0 Td
(QOF)Tj
2.245 0 Td
(is)Tj
0.8447 0 Td
(a)Tj
0.6577 0 Td
(pay-for-performance)Tj
8.6172 0 Td
(scheme)Tj
3.1975 0 Td
(whereby)Tj
3.6113 0 Td
(general)Tj
-32.4791 -1.2983 Td
(practices)Tj
3.736 0 Td
(are)Tj
1.4513 0 Td
(remunerated)Tj
5.3915 0 Td
(according)Tj
4.1839 0 Td
(to)Tj
1.0261 0 Td
(achievement)Tj
5.2668 0 Td
(of)Tj
1.0148 0 Td
(targets)Tj
2.8686 0 Td
(reflecting)Tj
3.9742 0 Td
(the)Tj
1.474 0 Td
(quality)Tj
2.9536 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
-34.3556 -1.2983 Td
(delivered)Tj
3.8834 0 Td
(by)Tj
1.1849 0 Td
(the)Tj
1.4683 0 Td
(practice)Tj
3.3789 0 Td
([)Tj
0.83 0.64 0.02 0 k
(23)Tj
0 g
(].)Tj
2.0749 0 Td
(Practice)Tj
3.4186 0 Td
(data)Tj
1.9162 0 Td
(collection)Tj
4.1102 0 Td
(for)Tj
1.389 0 Td
(QOF)Tj
2.2393 0 Td
(operates)Tj
3.5547 0 Td
(on)Tj
1.2755 0 Td
(an)Tj
1.2019 0 Td
(annual)Tj
2.9594 0 Td
(cyclical)Tj
-34.0552 -1.3039 Td
(basis)Tj
2.1486 0 Td
(from)Tj
2.2053 0 Td
(1)Tj
0.6974 0 Td
(April)Tj
2.3073 0 Td
(to)Tj
1.0205 0 Td
(31)Tj
1.1735 0 Td
(March.)Tj
3.0955 0 Td
(QOF)Tj
2.2393 0 Td
(has)Tj
1.5421 0 Td
(driven)Tj
2.8119 0 Td
(consistent)Tj
4.2576 0 Td
(electronic)Tj
4.1556 0 Td
(recording)Tj
4.1215 0 Td
(of)Tj
1.0148 0 Td
(data)Tj
1.9162 0 Td
(in)Tj
1.0375 0 Td
(gen-)Tj
-35.7446 -1.2982 Td
(eral)Tj
1.6951 0 Td
(practice)Tj
3.3788 0 Td
(and)Tj
1.7292 0 Td
(practices)Tj
3.7417 0 Td
(routinely)Tj
3.8607 0 Td
(record)Tj
2.846 0 Td
(data)Tj
1.9162 0 Td
(for)Tj
1.3833 0 Td
(incentivised)Tj
5.0286 0 Td
(conditions)Tj
4.4787 0 Td
(on)Tj
1.2756 0 Td
(investigations,)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 378.2551 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Variations)Tj
4.5779 0 Td
(in)Tj
0.978 0 Td
(achievement)Tj
5.7969 0 Td
(of)Tj
1.0417 0 Td
(indicator)Tj
3.6993 0 Td
(s)Tj
0.7157 0 Td
(in)Tj
0.978 0 Td
(general)Tj
3.4866 0 Td
(practice)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
0.83 0.64 0.02 0 k
81.5811 34.9228 m
237.8835 34.9228 l
h
f*
0 g
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.83 0.64 0.02 0 k
0.4748 0 Td
(https://doi.or)Tj
5.4142 0 Td
(g/10.137)Tj
3.8198 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.01779)Tj
4.089 0 Td
(49)Tj
0 g
2.0906 0 Td
(July)Tj
1.9701 0 Td
(13,)Tj
1.5874 0 Td
(2017)Tj
35.3483 0 Td
(3)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
73 0 obj
<>stream
endstream
endobj
74 0 obj
<>stream
endstream
endobj
75 0 obj
<>stream
endstream
endobj
76 0 obj
<>stream
endstream
endobj
77 0 obj
<>stream
endstream
endobj
78 0 obj
<>stream
endstream
endobj
79 0 obj
<>stream
BT
66.402 0 Td
(18)Tj
ET
Q
endstream
endobj
80 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 84 0 R/Contents 85 0 R/TrimBox[0 0 612 792]>>
endobj
84 0 obj
[86 0 R 87 0 R 88 0 R 89 0 R 90 0 R 91 0 R]
endobj
86 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref024)>>
endobj
87 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref008)>>
endobj
88 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.t001)>>
endobj
89 0 obj
<>/Border[0 0 0]/Dest(Lpone.0177949.t001)>>
endobj
90 0 obj
<>/Border[0 0 0]/A 92 0 R>>
endobj
92 0 obj
<>
endobj
91 0 obj
<>/Border[0 0 0]/A 93 0 R>>
endobj
93 0 obj
<>
endobj
85 0 obj
[94 0 R 95 0 R 96 0 R 97 0 R 98 0 R]
endobj
94 0 obj
<>stream
q
0.83 0.64 0.02 0 k
203.4142 693.2976 m
212.9386 693.2976 l
h
f*
390.5575 667.3323 m
395.3197 667.3323 l
h
f*
203.4142 654.3496 m
232.5543 654.3496 l
h
f*
0 g
1 j
1 J
0 w
10 0 0 10 200.0125 707.4141 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(prescriptions)Tj
5.4538 0 Td
(and)Tj
1.7291 0 Td
(intermediate)Tj
5.3234 0 Td
(outcomes,)Tj
4.3143 0 Td
(such)Tj
2.058 0 Td
(as)Tj
1.0148 0 Td
(blood)Tj
2.5171 0 Td
(pressure,)Tj
3.7984 0 Td
(or)Tj
1.0999 0 Td
(glycated)Tj
3.4922 0 Td
(haemoglobin)Tj
-30.801 -1.3039 Td
([)Tj
0.83 0.64 0.02 0 k
(24)Tj
0 g
(].)Tj
1.1962 -1.2982 Td
(Our)Tj
1.8708 0 Td
(dependent)Tj
4.4561 0 Td
(variables)Tj
3.719 0 Td
(were)Tj
2.1203 0 Td
(drawn)Tj
2.7893 0 Td
(from)Tj
2.2053 0 Td
(a)Tj
0.652 0 Td
(set)Tj
1.3039 0 Td
(of)Tj
1.0148 0 Td
(eighteen)Tj
3.6 0 Td
(`high)Tj
2.228 0 Td
(impact')Tj
3.1974 0 Td
(QIs)Tj
1.6668 0 Td
(developed)Tj
4.2746 0 Td
(by)Tj
-36.2945 -1.2983 Td
(an)Tj
1.2018 0 Td
(earlier,)Tj
2.9821 0 Td
(multidisciplinary)Tj
7.0639 0 Td
(consensus)Tj
4.2802 0 Td
(process)Tj
3.1862 0 Td
([)Tj
0.83 0.64 0.02 0 k
(8)Tj
0 g
(].)Tj
1.5987 0 Td
(The)Tj
1.7858 0 Td
(list)Tj
1.3946 0 Td
(was)Tj
1.6952 0 Td
(reduced)Tj
3.4469 0 Td
(to)Tj
1.0261 0 Td
(seven)Tj
2.4321 0 Td
(indicators)Tj
-32.0936 -1.2983 Td
(\()Tj
0.83 0.64 0.02 0 k
(Table)Tj
2.7779 0 Td
(1)Tj
0 g
(\))Tj
1.0375 0 Td
(following)Tj
3.9798 0 Td
(initial)Tj
2.5511 0 Td
(data)Tj
1.9106 0 Td
(collection)Tj
4.1102 0 Td
(and)Tj
1.7291 0 Td
(analysis.)Tj
3.5546 0 Td
(The)Tj
1.7802 0 Td
(level)Tj
2.0182 0 Td
(of)Tj
1.0148 0 Td
(scope)Tj
2.4492 0 Td
(for)Tj
1.3889 0 Td
(improvement)Tj
5.6693 0 Td
(and)Tj
ET
Q
q
0.45 0.36 0.35 0.01 k
1 j
1 J
0 w
200.0001 619.5033 m
576 619.5033 l
576 619.0033 l
200.0001 619.0033 l
f*
342.6633 619.0033 m
342.6633 606.5033 l
342.1633 606.5033 l
342.1633 619.0033 l
f*
342.1633 606.5033 m
200.0001 606.5033 l
200.0001 607.0034 l
342.1633 607.0034 l
f*
576 606.5033 m
342.6633 606.5033 l
342.6633 607.0034 l
576 607.0034 l
f*
342.6633 606.5033 m
342.6633 594.0034 l
342.1633 594.0034 l
342.1633 606.5033 l
f*
342.1633 594.0034 m
200.0001 594.0034 l
200.0001 594.5034 l
342.1633 594.5034 l
f*
576 594.0034 m
342.6633 594.0034 l
342.6633 594.5034 l
576 594.5034 l
f*
342.6633 594.0034 m
342.6633 505.5032 l
342.1633 505.5032 l
342.1633 594.0034 l
f*
342.1633 505.5032 m
200.0001 505.5032 l
200.0001 506.0032 l
342.1633 506.0032 l
f*
576 505.5032 m
342.6633 505.5032 l
342.6633 506.0032 l
576 506.0032 l
f*
342.6633 505.5032 m
342.6633 322.0027 l
342.1633 322.0027 l
342.1633 505.5032 l
f*
342.1633 322.0027 m
200.0001 322.0027 l
200.0001 322.5027 l
342.1633 322.5027 l
f*
576 322.0027 m
342.6633 322.0027 l
342.6633 322.5027 l
576 322.5027 l
f*
342.6633 322.0027 m
342.6633 271.5026 l
342.1633 271.5026 l
342.1633 322.0027 l
f*
342.1633 271.5026 m
200.0001 271.5026 l
200.0001 272.0027 l
342.1633 272.0027 l
f*
576 271.5026 m
342.6633 271.5026 l
342.6633 272.0027 l
576 272.0027 l
f*
342.6633 271.5026 m
342.6633 230.5026 l
342.1633 230.5026 l
342.1633 271.5026 l
f*
342.1633 230.5026 m
200.0001 230.5026 l
200.0001 231.0026 l
342.1633 231.0026 l
f*
576 230.5026 m
342.6633 230.5026 l
342.6633 231.0026 l
576 231.0026 l
f*
342.6633 230.5026 m
342.6633 218.0027 l
342.1633 218.0027 l
342.1633 230.5026 l
f*
342.1633 218.0027 m
200.0001 218.0027 l
200.0001 218.5027 l
342.1633 218.5027 l
f*
576 218.0027 m
342.6633 218.0027 l
342.6633 218.5027 l
576 218.5027 l
f*
342.6633 218.0027 m
342.6633 167.5026 l
342.1633 167.5026 l
342.1633 218.0027 l
f*
342.1633 167.5026 m
200.0001 167.5026 l
200.0001 168.0026 l
342.1633 168.0026 l
f*
576 167.5026 m
342.6633 167.5026 l
342.6633 168.0026 l
576 168.0026 l
f*
342.6633 167.5026 m
342.6633 126.5026 l
342.1633 126.5026 l
342.1633 167.5026 l
f*
342.1633 126.5026 m
200.0001 126.5026 l
200.0001 127.0026 l
342.1633 127.0026 l
f*
576 126.5026 m
342.6633 126.5026 l
342.6633 127.0026 l
576 127.0026 l
f*
342.6633 126.5026 m
342.6633 95.0026 l
342.1633 95.0026 l
342.1633 126.5026 l
f*
342.1633 95.0026 m
200.0001 95.0026 l
200.0001 95.5026 l
342.1633 95.5026 l
f*
576 95.0026 m
342.6633 95.0026 l
342.6633 95.5026 l
576 95.5026 l
f*
0.83 0.64 0.02 0 k
200.0126 81.9213 m
350.7591 81.9213 l
h
f*
0 g
7.9999 0 0 7.9999 200.0125 624.359 cm
BT
/F2 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Table)Tj
2.7992 0 Td
(1.)Tj
1.2614 0 Td
(Details)Tj
3.4441 0 Td
(of)Tj
1.1552 0 Td
(the)Tj
1.7008 0 Td
(clinical)Tj
3.5646 0 Td
(indicators)Tj
4.9394 0 Td
(included)Tj
4.2874 0 Td
(in)Tj
1.1055 0 Td
(the)Tj
1.7008 0 Td
(study.)Tj
0 Tc
-25.9584 -1.8567 Td
(Indicato)Tj
3.8268 0 Td
(r)Tj
14.2512 0 Td
(Description)Tj
/F10 1 Tf
-18.078 -1.5661 Td
(Proces)Tj
3.0897 0 Td
(s)Tj
0.73 0 Td
(indicators)Tj
/F0 1 Tf
-2.8276 -1.5591 Td
(1.)Tj
1.063 0 Td
(Diabetes:)Tj
4.4292 0 Td
(process)Tj
3.4724 0 Td
(es)Tj
1.2827 0 Td
(of)Tj
1.063 0 Td
(care)Tj
5.9032 0 Td
(A)Tj
0.8929 0 Td
(composite)Tj
4.7623 0 Td
(indicator)Tj
3.9756 0 Td
(recording)Tj
4.3654 0 Td
(the)Tj
1.6087 0 Td
(proportio)Tj
3.9118 0 Td
(n)Tj
0.7866 0 Td
(of)Tj
1.0559 0 Td
(eligible)Tj
3.3024 0 Td
(patients)Tj
-24.6616 -1.1905 Td
(that)Tj
1.8921 0 Td
(received)Tj
3.9757 0 Td
(all)Tj
1.2189 0 Td
(of)Tj
1.063 0 Td
(nine)Tj
2.0976 0 Td
(recommen)Tj
4.6914 0 Td
(ded)Tj
1.8851 0 Td
(processe)Tj
4.0252 0 Td
(s)Tj
0.7299 0 Td
(of)Tj
1.063 0 Td
(care:)Tj
2.4378 0 Td
(blood)Tj
-25.0797 -1.1835 Td
(pressure)Tj
4.0961 0 Td
(\(BP\))Tj
2.2181 0 Td
(measureme)Tj
5.2442 0 Td
(nt,)Tj
1.3464 0 Td
(glycated)Tj
3.926 0 Td
(haemog)Tj
3.5788 0 Td
(lobin)Tj
2.3174 0 Td
(\(HbA1c\))Tj
-22.727 -1.1906 Td
(measurem)Tj
4.6914 0 Td
(ent,)Tj
1.8921 0 Td
(cholesterol)Tj
5.0316 0 Td
(measurem)Tj
4.6913 0 Td
(ent,)Tj
1.8922 0 Td
(urine)Tj
2.4307 0 Td
(albumin:)Tj
-20.6293 -1.1834 Td
(creatinine)Tj
4.5284 0 Td
(ratio)Tj
2.1614 0 Td
(\(ACR\))Tj
2.9906 0 Td
(/)Tj
0.5102 0 Td
(protein:crea)Tj
5.2442 0 Td
(tinine)Tj
2.6008 0 Td
(\(PCR\))Tj
2.9906 0 Td
(testing)Tj
3.1606 0 Td
(or)Tj
-24.1868 -1.1906 Td
(proteinuri)Tj
4.1315 0 Td
(a)Tj
0.7796 0 Td
(code,)Tj
2.6646 0 Td
(estimate)Tj
3.7559 0 Td
(d)Tj
0.7795 0 Td
(Glomerula)Tj
4.578 0 Td
(r)Tj
0.5669 0 Td
(Filtration)Tj
4.0394 0 Td
(Rate)Tj
2.3245 0 Td
(\(eGFR\))Tj
3.5575 0 Td
(or)Tj
-27.1774 -1.1835 Td
(serum)Tj
2.9906 0 Td
(creatinine)Tj
4.5284 0 Td
(testing,)Tj
3.4441 0 Td
(foot)Tj
1.8921 0 Td
(review,)Tj
3.3733 0 Td
(retinal)Tj
2.9268 0 Td
(screening,)Tj
4.8118 0 Td
(body)Tj
-23.9671 -1.1905 Td
(mass)Tj
2.6079 0 Td
(index)Tj
2.6008 0 Td
(\(BMI\))Tj
2.6646 0 Td
(recording,)Tj
4.6489 0 Td
(smoking)Tj
3.926 0 Td
(status,)Tj
3.1677 0 Td
(within)Tj
2.7638 0 Td
(the)Tj
1.6087 0 Td
(last)Tj
1.7787 0 Td
(15)Tj
-25.7671 -1.1906 Td
(months)Tj
3.4937 0 Td
(\(six)Tj
1.7717 0 Td
(months)Tj
3.4937 0 Td
(for)Tj
1.3961 0 Td
(HbA1c)Tj
3.2103 0 Td
(measurem)Tj
4.6913 0 Td
(ent\).)Tj
-35.2703 -1.5591 Td
(2.)Tj
1.063 0 Td
(Risky)Tj
2.6575 0 Td
(prescribing)Tj
13.493 0 Td
(A)Tj
0.8929 0 Td
(set)Tj
1.5591 0 Td
(of)Tj
1.063 0 Td
(nine)Tj
2.0976 0 Td
(indicators)Tj
4.4788 0 Td
(largely)Tj
3.1465 0 Td
(focusing)Tj
3.926 0 Td
(on)Tj
1.3323 0 Td
(avoiding)Tj
3.9189 0 Td
(adverse)Tj
-22.4151 -1.1905 Td
(gastrointest)Tj
5.1378 0 Td
(inal,)Tj
2.0481 0 Td
(renal)Tj
2.4307 0 Td
(and)Tj
1.8851 0 Td
(cardiac)Tj
3.4299 0 Td
(effects)Tj
3.1678 0 Td
(of)Tj
1.0559 0 Td
(non-steroida)Tj
5.5134 0 Td
(l)Tj
0.4536 0 Td
(anti-)Tj
-25.1223 -1.1835 Td
(inflammat)Tj
4.3087 0 Td
(ory)Tj
1.6158 0 Td
(drugs)Tj
2.7071 0 Td
(\(NSAIDs\))Tj
4.4362 0 Td
(and)Tj
1.8851 0 Td
(anti-pl)Tj
2.6929 0 Td
(atelet)Tj
2.6646 0 Td
(drugs:)Tj
2.9906 0 Td
(prescribing)Tj
-23.301 -1.1906 Td
(a)Tj
0.7795 0 Td
(traditional)Tj
4.5284 0 Td
(oral)Tj
1.8851 0 Td
(NSAID)Tj
3.274 0 Td
(or)Tj
1.1126 0 Td
(low-do)Tj
2.9126 0 Td
(se)Tj
1.2827 0 Td
(aspirin)Tj
3.1465 0 Td
(in)Tj
0.9992 0 Td
(patients)Tj
3.7064 0 Td
(with)Tj
1.9984 0 Td
(a)Tj
-25.6254 -1.1834 Td
(history)Tj
3.1607 0 Td
(of)Tj
1.0559 0 Td
(peptic)Tj
2.8842 0 Td
(ulceration)Tj
4.5284 0 Td
(without)Tj
3.3733 0 Td
(co-prescri)Tj
4.3583 0 Td
(ption)Tj
2.3811 0 Td
(of)Tj
1.063 0 Td
(gastro-)Tj
-22.8049 -1.1906 Td
(protection;)Tj
4.8756 0 Td
(prescribin)Tj
4.2946 0 Td
(g)Tj
0.7795 0 Td
(a)Tj
0.7795 0 Td
(traditional)Tj
4.5284 0 Td
(oral)Tj
1.8851 0 Td
(NSAID)Tj
3.274 0 Td
(in)Tj
0.9992 0 Td
(patients)Tj
3.7064 0 Td
(aged)Tj
-25.1223 -1.1835 Td
(75)Tj
1.3323 0 Td
(years)Tj
2.6575 0 Td
(or)Tj
1.1126 0 Td
(over)Tj
2.1614 0 Td
(without)Tj
3.3804 0 Td
(co-presc)Tj
3.8055 0 Td
(ription)Tj
2.9339 0 Td
(of)Tj
1.063 0 Td
(gastro-)Tj
3.0898 0 Td
(protection;)Tj
-21.5364 -1.1905 Td
(prescribing)Tj
5.0811 0 Td
(of)Tj
1.063 0 Td
(a)Tj
0.7796 0 Td
(traditional)Tj
4.5284 0 Td
(oral)Tj
1.8779 0 Td
(NSAID)Tj
3.2741 0 Td
(and)Tj
1.8779 0 Td
(aspirin)Tj
3.1536 0 Td
(in)Tj
0.9921 0 Td
(patients)Tj
-22.6277 -1.1906 Td
(aged)Tj
2.4307 0 Td
(65)Tj
1.3323 0 Td
(years)Tj
2.6575 0 Td
(or)Tj
1.1126 0 Td
(over)Tj
2.1615 0 Td
(without)Tj
3.3803 0 Td
(co-prescr)Tj
4.1386 0 Td
(iption)Tj
2.6008 0 Td
(of)Tj
1.063 0 Td
(gastro-)Tj
-20.8773 -1.1835 Td
(protection;)Tj
4.8756 0 Td
(prescribin)Tj
4.2946 0 Td
(g)Tj
0.7795 0 Td
(of)Tj
1.063 0 Td
(aspirin)Tj
3.1465 0 Td
(and)Tj
1.885 0 Td
(clopid)Tj
2.5796 0 Td
(ogrel)Tj
2.4378 0 Td
(in)Tj
0.9921 0 Td
(patients)Tj
3.7134 0 Td
(aged)Tj
-25.7671 -1.1905 Td
(65)Tj
1.3323 0 Td
(years)Tj
2.6575 0 Td
(or)Tj
1.1126 0 Td
(over)Tj
2.1614 0 Td
(without)Tj
3.3804 0 Td
(co-presc)Tj
3.8055 0 Td
(ription)Tj
2.9339 0 Td
(of)Tj
1.063 0 Td
(gastro-)Tj
3.0898 0 Td
(protection;)Tj
-21.5364 -1.1835 Td
(prescribing)Tj
5.0811 0 Td
(of)Tj
1.063 0 Td
(warfarin)Tj
3.756 0 Td
(and)Tj
1.885 0 Td
(a)Tj
0.7796 0 Td
(traditional)Tj
4.5284 0 Td
(oral)Tj
1.8779 0 Td
(NSAID)Tj
3.2741 0 Td
(without)Tj
3.3732 0 Td
(co-)Tj
-25.6183 -1.1906 Td
(prescriptio)Tj
4.578 0 Td
(n)Tj
0.7795 0 Td
(of)Tj
1.063 0 Td
(gastro-prote)Tj
5.3576 0 Td
(ction;)Tj
2.6078 0 Td
(prescribing)Tj
5.0812 0 Td
(of)Tj
1.063 0 Td
(warfarin)Tj
3.7559 0 Td
(and)Tj
1.8851 0 Td
(low-)Tj
-26.1711 -1.1834 Td
(dose)Tj
2.3811 0 Td
(aspirin)Tj
3.1465 0 Td
(or)Tj
1.1126 0 Td
(clopidogrel)Tj
5.0174 0 Td
(without)Tj
3.3732 0 Td
(co-prescription)Tj
6.7465 0 Td
(of)Tj
1.056 0 Td
(gastro-)Tj
-22.8333 -1.1906 Td
(protection;)Tj
4.8756 0 Td
(prescribin)Tj
4.2946 0 Td
(g)Tj
0.7795 0 Td
(an)Tj
1.3323 0 Td
(oral)Tj
1.885 0 Td
(NSAID)Tj
3.267 0 Td
(in)Tj
0.9992 0 Td
(patients)Tj
3.7063 0 Td
(with)Tj
1.9985 0 Td
(heart)Tj
-23.138 -1.1906 Td
(failure;)Tj
3.2103 0 Td
(prescribing)Tj
5.0811 0 Td
(an)Tj
1.3323 0 Td
(oral)Tj
1.878 0 Td
(NSAID)Tj
3.274 0 Td
(in)Tj
0.9992 0 Td
(patients)Tj
3.7064 0 Td
(prescribed)Tj
4.8614 0 Td
(both)Tj
2.1615 0 Td
(a)Tj
-26.5042 -1.1834 Td
(diuretic)Tj
3.43 0 Td
(and)Tj
1.8779 0 Td
(an)Tj
1.3323 0 Td
(angiotensi)Tj
4.5142 0 Td
(n-converting)Tj
5.4638 0 Td
(-enzyme)Tj
4.0394 0 Td
(inhibitor)Tj
3.6993 0 Td
(\(ACE)Tj
-24.3569 -1.1906 Td
(inhibitor\))Tj
4.0323 0 Td
(or)Tj
1.1126 0 Td
(angiote)Tj
3.2457 0 Td
(nsin)Tj
2.0481 0 Td
(receptor)Tj
3.8764 0 Td
(blocker)Tj
3.4299 0 Td
(\(ARB\);)Tj
3.2174 0 Td
(and)Tj
1.885 0 Td
(prescribin)Tj
4.2946 0 Td
(g)Tj
-27.142 -1.1835 Td
(an)Tj
1.3323 0 Td
(oral)Tj
1.878 0 Td
(NSAID)Tj
3.274 0 Td
(in)Tj
0.9992 0 Td
(patients)Tj
3.7064 0 Td
(with)Tj
1.9984 0 Td
(chronic)Tj
3.4299 0 Td
(kidney)Tj
3.0898 0 Td
(disease)Tj
3.6497 0 Td
(\(CKD\))Tj
-40.5712 -1.5661 Td
(3.)Tj
1.063 0 Td
(Anticoagula)Tj
5.1803 0 Td
(tion)Tj
1.8284 0 Td
(in)Tj
0.9992 0 Td
(atrial)Tj
2.3811 0 Td
(fibrillation)Tj
-12.4441 -1.1835 Td
(\(AF\))Tj
2.1685 0 Td
(and)Tj
1.885 0 Td
(risk)Tj
1.7717 0 Td
(of)Tj
1.063 0 Td
(stroke)Tj
11.3174 1.1835 Td
(A)Tj
0.8929 0 Td
(single)Tj
2.8205 0 Td
(indicator)Tj
3.9756 0 Td
(examining)Tj
4.7481 0 Td
(recommen)Tj
4.6914 0 Td
(ded)Tj
1.885 0 Td
(treatment)Tj
4.4363 0 Td
(of)Tj
1.0559 0 Td
(patients)Tj
-24.5057 -1.1835 Td
(with)Tj
1.9984 0 Td
(AF)Tj
1.5024 0 Td
(and)Tj
1.8851 0 Td
(at)Tj
1.0559 0 Td
(greater)Tj
3.3803 0 Td
(risk)Tj
1.7788 0 Td
(of)Tj
1.0559 0 Td
(stroke.)Tj
3.2244 0 Td
(The)Tj
1.9418 0 Td
(proportio)Tj
3.9118 0 Td
(n)Tj
0.7866 0 Td
(of)Tj
1.056 0 Td
(patients)Tj
-23.5774 -1.1906 Td
(with)Tj
1.9984 0 Td
(a)Tj
0.7796 0 Td
(record)Tj
3.0402 0 Td
(of)Tj
1.063 0 Td
(AF)Tj
1.5094 0 Td
(and)Tj
1.878 0 Td
(a)Tj
0.7795 0 Td
(score)Tj
2.6646 0 Td
(of)Tj
1.0559 0 Td
(two)Tj
1.7788 0 Td
(or)Tj
1.1126 0 Td
(higher)Tj
2.9835 0 Td
(on)Tj
1.3323 0 Td
(the)Tj
1.6086 0 Td
(CHADS2)Tj
-23.5844 -1.1905 Td
(risk)Tj
1.7788 0 Td
(tool)Tj
1.8283 0 Td
(who)Tj
2.0481 0 Td
(have)Tj
2.3811 0 Td
(a)Tj
0.7795 0 Td
(current)Tj
3.3237 0 Td
(prescripti)Tj
4.0252 0 Td
(on)Tj
1.3323 0 Td
(for)Tj
1.3961 0 Td
(anti-coagu)Tj
4.6276 0 Td
(lation)Tj
-23.5207 -1.1835 Td
(therapy.)Tj
-17.2135 -1.5661 Td
(4.)Tj
1.063 0 Td
(Secondar)Tj
4.2449 0 Td
(y)Tj
0.7299 0 Td
(prevention)Tj
4.8615 0 Td
(of)Tj
-11.8914 -1.1835 Td
(myocardi)Tj
4.0252 0 Td
(al)Tj
0.9992 0 Td
(infarction)Tj
4.2591 0 Td
(\(MI\))Tj
8.9221 1.1835 Td
(A)Tj
0.8929 0 Td
(single)Tj
2.8205 0 Td
(indicator)Tj
3.9756 0 Td
(showing)Tj
3.8623 0 Td
(the)Tj
1.6157 0 Td
(proporti)Tj
3.3591 0 Td
(on)Tj
1.3323 0 Td
(of)Tj
1.063 0 Td
(patients)Tj
3.7063 0 Td
(with)Tj
1.9985 0 Td
(a)Tj
-24.6262 -1.1835 Td
(lifetime)Tj
3.3803 0 Td
(record)Tj
3.0402 0 Td
(of)Tj
1.063 0 Td
(MI)Tj
1.3394 0 Td
(who)Tj
2.0481 0 Td
(are)Tj
1.6653 0 Td
(receiving)Tj
4.1953 0 Td
(the)Tj
1.6087 0 Td
(recommen)Tj
4.6914 0 Td
(ded)Tj
1.885 0 Td
(four)Tj
-24.9167 -1.1906 Td
(drugs:)Tj
2.9906 0 Td
(ACE)Tj
2.2748 0 Td
(inhibitor)Tj
3.6992 0 Td
(or)Tj
1.1126 0 Td
(ARB,)Tj
2.5583 0 Td
(aspirin)Tj
3.1465 0 Td
(or)Tj
1.1126 0 Td
(antiplatelet)Tj
4.7977 0 Td
(,)Tj
0.5102 0 Td
(beta-block)Tj
4.578 0 Td
(er,)Tj
-26.7805 -1.1835 Td
(and)Tj
1.8851 0 Td
(statin.)Tj
/F10 1 Tf
-20.0907 -1.5661 Td
(Outcome)Tj
4.2661 0 Td
(indicators)Tj
/F0 1 Tf
-3.274 -1.5591 Td
(5.)Tj
1.063 0 Td
(Diabetes)Tj
4.1457 0 Td
(control)Tj
12.0048 0 Td
(A)Tj
0.8929 0 Td
(composite)Tj
4.7623 0 Td
(indicator)Tj
3.9756 0 Td
(recording)Tj
4.3654 0 Td
(the)Tj
1.6087 0 Td
(proportio)Tj
3.9118 0 Td
(n)Tj
0.7866 0 Td
(of)Tj
1.0559 0 Td
(patients)Tj
3.7134 0 Td
(with)Tj
-25.0726 -1.1905 Td
(Type)Tj
2.4449 0 Td
(2)Tj
0.7795 0 Td
(diabete)Tj
3.2457 0 Td
(s)Tj
0.73 0 Td
(that)Tj
1.8921 0 Td
(achieve)Tj
3.6496 0 Td
(each)Tj
2.3741 0 Td
(of)Tj
1.063 0 Td
(three)Tj
2.4945 0 Td
(recommen)Tj
4.6914 0 Td
(ded)Tj
1.885 0 Td
(target)Tj
-25.2498 -1.1835 Td
(levels:)Tj
3.0473 0 Td
(BP)Tj
/F6 1 Tf
1.559 0 Td
[( )]TJ
/F0 1 Tf
(140/80)Tj
3.841 0 Td
(mmHg)Tj
3.1607 0 Td
(\(or)Tj
/F6 1 Tf
1.4457 0 Td
[( )]TJ
/F0 1 Tf
(130/80)Tj
3.8409 0 Td
(mmHg)Tj
3.1607 0 Td
(if)Tj
0.7228 0 Td
(kidney,)Tj
3.3804 0 Td
(eye)Tj
1.8283 0 Td
(or)Tj
-25.9868 -1.1906 Td
(cerebrovas)Tj
4.9111 0 Td
(cular)Tj
2.3811 0 Td
(damage)Tj
3.5788 0 Td
(\),)Tj
0.8433 0 Td
(HbA1c)Tj
/F11 1 Tf
3.2102 0 Td
()Tj
/F0 1 Tf
(59)Tj
2.1048 0 Td
(mmol/m)Tj
3.5362 0 Td
(ol,)Tj
1.2827 0 Td
(and)Tj
-21.8482 -1.1905 Td
(cholestero)Tj
4.578 0 Td
(l)Tj
/F11 1 Tf
0.4535 0 Td
()Tj
/F0 1 Tf
(5)Tj
1.5449 0 Td
(mmol/l.)Tj
-23.7899 -1.5591 Td
(6.)Tj
1.063 0 Td
(Blood)Tj
2.7638 0 Td
(pressure)Tj
4.0961 0 Td
(control)Tj
3.2102 0 Td
(in)Tj
-12.1252 -1.1906 Td
(hypertens)Tj
4.3583 0 Td
(ion)Tj
13.8473 1.1906 Td
(A)Tj
0.8929 0 Td
(combinatio)Tj
4.7977 0 Td
(n)Tj
0.7795 0 Td
(of)Tj
1.063 0 Td
(two)Tj
1.7788 0 Td
(indicators)Tj
4.4788 0 Td
(recordi)Tj
3.026 0 Td
(ng)Tj
1.3323 0 Td
(the)Tj
1.6157 0 Td
(proporti)Tj
3.3591 0 Td
(on)Tj
1.3323 0 Td
(of)Tj
-24.4561 -1.1906 Td
(patients)Tj
3.7063 0 Td
(achieving)Tj
4.415 0 Td
(individual,)Tj
4.6347 0 Td
(age-depen)Tj
4.7339 0 Td
(dent)Tj
2.1614 0 Td
(targets)Tj
3.2741 0 Td
(in)Tj
0.9992 0 Td
(the)Tj
-23.9246 -1.1834 Td
(previous)Tj
3.9827 0 Td
(nine)Tj
2.0977 0 Td
(months:)Tj
3.7701 0 Td
(BP)Tj
/F6 1 Tf
1.559 0 Td
[( )]TJ
/F0 1 Tf
(140/90)Tj
3.841 0 Td
(mmHg)Tj
3.1607 0 Td
(if)Tj
0.7299 0 Td
(aged)Tj
2.4307 0 Td
(under)Tj
2.7638 0 Td
(80)Tj
1.3323 0 Td
(years,)Tj
-25.6679 -1.1906 Td
(or)Tj
/F6 1 Tf
1.1126 0 Td
[( )]TJ
/F0 1 Tf
(150/90)Tj
3.841 0 Td
(mmHg)Tj
3.1606 0 Td
(if)Tj
0.73 0 Td
(aged)Tj
2.4307 0 Td
(80)Tj
1.3323 0 Td
(years)Tj
2.6575 0 Td
(or)Tj
1.1126 0 Td
(more.)Tj
-33.5908 -1.5591 Td
(7.)Tj
1.063 0 Td
(Blood)Tj
2.7638 0 Td
(pressure)Tj
4.0961 0 Td
(control)Tj
3.2102 0 Td
(in)Tj
0.9993 0 Td
(chroni)Tj
2.6929 0 Td
(c)Tj
-15.8174 -1.1905 Td
(kidney)Tj
3.0968 0 Td
(disease)Tj
3.6426 0 Td
(\(CKD\))Tj
11.4662 1.1905 Td
(A)Tj
0.8929 0 Td
(combinatio)Tj
4.7977 0 Td
(n)Tj
0.7795 0 Td
(of)Tj
1.063 0 Td
(two)Tj
1.7788 0 Td
(indicators)Tj
4.4788 0 Td
(assess)Tj
3.0898 0 Td
(ing)Tj
1.5519 0 Td
(the)Tj
1.6087 0 Td
(achievem)Tj
4.2449 0 Td
(ent)Tj
1.6158 0 Td
(of)Tj
-25.9018 -1.1905 Td
(recommen)Tj
4.6914 0 Td
(ded)Tj
1.885 0 Td
(BP)Tj
1.5591 0 Td
(targets)Tj
3.274 0 Td
(in)Tj
0.9993 0 Td
(specific)Tj
3.5362 0 Td
(patient)Tj
3.2103 0 Td
(groups:)Tj
/F6 1 Tf
3.5433 0 Td
[( )]TJ
/F0 1 Tf
(140/85)Tj
-22.6986 -1.1835 Td
(mmHg,)Tj
3.437 0 Td
(or)Tj
/F6 1 Tf
1.1126 0 Td
[( )]TJ
/F0 1 Tf
(130/80)Tj
3.8481 0 Td
(mmHg)Tj
3.1536 0 Td
(if)Tj
0.7299 0 Td
(record)Tj
3.0473 0 Td
(of)Tj
1.0559 0 Td
(diabetes)Tj
3.9827 0 Td
(or)Tj
1.1126 0 Td
(proteinu)Tj
3.5788 0 Td
(ria.)Tj
0.83 0.64 0.02 0 k
/F8 1 Tf
-0.025 Tc
-43.2641 -1.878 Td
(https://d)Tj
3.0827 0 Td
(oi.org/10.1371/j)Tj
5.9173 0 Td
(ournal.pon)Tj
3.9827 0 Td
(e.0177949.t00)Tj
5.3859 0 Td
(1)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 378.2551 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Variations)Tj
4.5779 0 Td
(in)Tj
0.978 0 Td
(achievement)Tj
5.7969 0 Td
(of)Tj
1.0417 0 Td
(indicator)Tj
3.6993 0 Td
(s)Tj
0.7157 0 Td
(in)Tj
0.978 0 Td
(general)Tj
3.4866 0 Td
(practice)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
0.83 0.64 0.02 0 k
81.5811 34.9228 m
237.8835 34.9228 l
h
f*
0 g
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.83 0.64 0.02 0 k
0.4748 0 Td
(https://doi.or)Tj
5.4142 0 Td
(g/10.137)Tj
3.8198 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.01779)Tj
4.089 0 Td
(49)Tj
0 g
2.0906 0 Td
(July)Tj
1.9701 0 Td
(13,)Tj
1.5874 0 Td
(2017)Tj
35.3483 0 Td
(4)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
95 0 obj
<>stream
endstream
endobj
96 0 obj
<>stream
endstream
endobj
97 0 obj
<>stream
endstream
endobj
98 0 obj
<>stream
BT
66.402 0 Td
(18)Tj
ET
Q
endstream
endobj
99 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 101 0 R/Contents 102 0 R/TrimBox[0 0 612 792]>>
endobj
101 0 obj
[103 0 R 104 0 R 105 0 R 106 0 R 107 0 R 108 0 R 109 0 R 110 0 R]
endobj
103 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref025)>>
endobj
104 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref026)>>
endobj
105 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref008)>>
endobj
106 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref027)>>
endobj
107 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref028)>>
endobj
108 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref029)>>
endobj
109 0 obj
<>/Border[0 0 0]/Dest(Rpone.0177949.ref030)>>
endobj
110 0 obj
<>/Border[0 0 0]/A 111 0 R>>
endobj
111 0 obj
<>
endobj
102 0 obj
[112 0 R 113 0 R 114 0 R 115 0 R 116 0 R 117 0 R 118 0 R 119 0 R 120 0 R]
endobj
112 0 obj
<>stream
q
0.83 0.64 0.02 0 k
203.4142 511.3134 m
212.9386 511.3134 l
h
f*
217.3606 511.3134 m
226.885 511.3134 l
h
f*
371.7921 446.3433 m
376.5543 446.3433 l
h
f*
503.7165 420.3213 m
513.2409 420.3213 l
h
f*
517.7197 420.3213 m
527.2441 420.3213 l
h
f*
356.6551 277.3417 m
366.1795 277.3417 l
h
f*
340.7811 81.9213 m
350.3055 81.9213 l
h
f*
0 g
1 j
1 J
0 w
10 0 0 10 200.0125 707.4141 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(potential)Tj
3.7587 0 Td
(for)Tj
1.3889 0 Td
(intervention)Tj
5.1761 0 Td
(were)Tj
2.1203 0 Td
(of)Tj
1.0148 0 Td
(primary)Tj
3.4582 0 Td
(importance)Tj
4.8302 0 Td
(in)Tj
1.0318 0 Td
(the)Tj
1.474 0 Td
(selection)Tj
3.7134 0 Td
(process.)Tj
3.4129 0 Td
(Other)Tj
2.5852 0 Td
(indica-)Tj
-33.9645 -1.3039 Td
(tors)Tj
1.7574 0 Td
(were)Tj
2.1203 0 Td
(rejected)Tj
3.3676 0 Td
(due)Tj
1.7007 0 Td
(to)Tj
1.0262 0 Td
(concerns)Tj
3.8267 0 Td
(about)Tj
2.4945 0 Td
(the)Tj
1.4683 0 Td
(reliability)Tj
4.0025 0 Td
(of)Tj
1.0148 0 Td
(routinely)Tj
3.8665 0 Td
(collected)Tj
3.736 0 Td
(data)Tj
1.9162 0 Td
(or)Tj
1.0998 0 Td
(uncer-)Tj
-33.3975 -1.2982 Td
(tainty)Tj
2.5171 0 Td
(about)Tj
2.4945 0 Td
(the)Tj
1.474 0 Td
(ongoing)Tj
3.5263 0 Td
(use)Tj
1.5307 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4683 0 Td
(clinical)Tj
3.0784 0 Td
(indicator.)Tj
-15.9079 -1.2983 Td
(Four)Tj
2.1543 0 Td
(indicators)Tj
4.2292 0 Td
(focused)Tj
3.2769 0 Td
(on)Tj
1.2756 0 Td
(processes)Tj
3.9684 0 Td
(of)Tj
1.0148 0 Td
(care)Tj
1.8709 0 Td
(\(e.g.)Tj
1.8992 0 Td
(prescribing)Tj
4.7452 0 Td
(or)Tj
1.0998 0 Td
(testing\))Tj
3.2201 0 Td
(and)Tj
1.7292 0 Td
(three)Tj
2.2677 0 Td
(on)Tj
1.2755 0 Td
(clini-)Tj
-35.223 -1.2983 Td
(cal)Tj
1.3209 0 Td
(outcomes)Tj
4.0875 0 Td
(\(the)Tj
1.8085 0 Td
(achievement)Tj
5.2668 0 Td
(of)Tj
1.0147 0 Td
(recommended)Tj
6.0378 0 Td
(targets)Tj
2.8686 0 Td
(for)Tj
1.389 0 Td
(the)Tj
1.4684 0 Td
(intermediate)Tj
5.3234 0 Td
(health)Tj
2.6759 0 Td
(outcomes)Tj
-33.2615 -1.3039 Td
(of)Tj
1.0147 0 Td
(blood)Tj
2.5115 0 Td
(pressure,)Tj
3.8041 0 Td
(cholesterol)Tj
4.5524 0 Td
(and)Tj
1.7348 0 Td
(glycaemic)Tj
4.1782 0 Td
(control\).)Tj
3.6851 0 Td
(Several)Tj
3.05 0 Td
(indicator)Tj
3.8608 0 Td
(sets)Tj
1.6667 0 Td
(consisted)Tj
3.9345 0 Td
(of)Tj
1.0148 0 Td
(multi-)Tj
-35.0076 -1.2982 Td
(ple)Tj
1.4059 0 Td
(individual)Tj
4.286 0 Td
(recommendations)Tj
7.5004 0 Td
(that)Tj
1.7802 0 Td
(were)Tj
2.1203 0 Td
(then)Tj
2.0182 0 Td
(pooled)Tj
2.948 0 Td
(to)Tj
1.0262 0 Td
(permit)Tj
2.9196 0 Td
(analysis)Tj
3.3279 0 Td
(of)Tj
1.0148 0 Td
(achievement.)Tj
-30.3475 -1.2983 Td
(Two)Tj
2.0182 0 Td
(of)Tj
1.0148 0 Td
(these)Tj
2.2564 0 Td
(were)Tj
2.1203 0 Td
(composites,)Tj
4.9322 0 Td
(assessing)Tj
3.8041 0 Td
(the)Tj
1.4683 0 Td
(degree)Tj
2.8573 0 Td
(to)Tj
1.0205 0 Td
(which)Tj
/F12 1 Tf
2.6532 0 Td
[()11()4()]TJ
/F5 1 Tf
1.1792 0 Td
(recommended)Tj
6.0321 0 Td
(care)Tj
1.8709 0 Td
(processes)Tj
-33.2275 -1.3039 Td
(or)Tj
1.0941 0 Td
(treatment)Tj
4.1386 0 Td
(targets)Tj
2.8743 0 Td
(were)Tj
2.1203 0 Td
(achieved)Tj
3.702 0 Td
(for)Tj
1.3833 0 Td
(individual)Tj
4.2916 0 Td
(patients)Tj
3.3676 0 Td
(\(e.g.)Tj
1.8992 0 Td
(blood)Tj
2.5115 0 Td
(pressure,)Tj
3.804 0 Td
(cholesterol)Tj
4.5581 0 Td
(and)Tj
-35.7446 -1.2983 Td
(glycaemic)Tj
4.1782 0 Td
(values)Tj
2.6645 0 Td
(within)Tj
2.812 0 Td
(recommended)Tj
6.0377 0 Td
(ranges)Tj
2.8233 0 Td
(for)Tj
1.3833 0 Td
(patients)Tj
3.3732 0 Td
(with)Tj
1.9956 0 Td
(Type)Tj
2.228 0 Td
(2)Tj
0.6917 0 Td
(diabetes)Tj
3.4639 0 Td
([indicator)Tj
4.2066 0 Td
(5:)Tj
-35.858 -1.2983 Td
(diabetes)Tj
3.4582 0 Td
(control]\).)Tj
4.0308 0 Td
(Others)Tj
2.948 0 Td
(were)Tj
2.1204 0 Td
(formed)Tj
3.1577 0 Td
(from)Tj
2.2054 0 Td
(combinations)Tj
5.7089 0 Td
(of)Tj
1.0148 0 Td
(individual)Tj
4.2916 0 Td
(recommendations,)Tj
-28.9358 -1.3039 Td
(but)Tj
1.5533 0 Td
(could)Tj
2.4491 0 Td
(not)Tj
1.5761 0 Td
(be)Tj
1.1509 0 Td
(considered)Tj
4.5977 0 Td
(composites)Tj
4.7055 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(truest)Tj
2.5002 0 Td
(sense)Tj
2.3357 0 Td
(as)Tj
1.0148 0 Td
(they)Tj
1.9275 0 Td
(did)Tj
1.5421 0 Td
(not)Tj
1.576 0 Td
(necessarily)Tj
4.5298 0 Td
(all)Tj
1.1508 0 Td
(apply)Tj
-35.1153 -1.2982 Td
(to)Tj
1.0261 0 Td
(a)Tj
0.6519 0 Td
(single)Tj
2.5342 0 Td
(individual.)Tj
4.5127 0 Td
(For)Tj
1.6214 0 Td
(example,)Tj
3.7758 0 Td
(the)Tj
1.4683 0 Td
(risky)Tj
2.1713 0 Td
(prescribing)Tj
4.7452 0 Td
(indicator)Tj
3.8664 0 Td
(\(indicator)Tj
4.2009 0 Td
(2\))Tj
1.0375 0 Td
(combined)Tj
-31.6117 -1.2983 Td
(nine)Tj
2.0069 0 Td
(individual)Tj
4.2859 0 Td
(instances)Tj
3.8891 0 Td
(of)Tj
1.0148 0 Td
(prescribing)Tj
4.7395 0 Td
(that)Tj
1.7802 0 Td
(might)Tj
2.5965 0 Td
(be)Tj
1.1509 0 Td
(considered)Tj
4.6034 0 Td
(high-risk;)Tj
4.0762 0 Td
(six)Tj
1.3152 0 Td
(concerned)Tj
4.4164 0 Td
(gas-)Tj
-35.875 -1.3039 Td
(tro-intestinal)Tj
5.4368 0 Td
(risks,)Tj
2.3017 0 Td
(two)Tj
1.7121 0 Td
(renal)Tj
2.245 0 Td
(risks)Tj
2.075 0 Td
(and)Tj
1.7291 0 Td
(one)Tj
1.7008 0 Td
(heart)Tj
2.2733 0 Td
(failure.)Tj
3.0047 0 Td
(These)Tj
2.5682 0 Td
(have)Tj
2.058 0 Td
(been)Tj
2.1203 0 Td
(detailed)Tj
3.3675 0 Td
(elsewhere)Tj
-32.5925 -1.2983 Td
([)Tj
0.83 0.64 0.02 0 k
(25)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7347 0 Td
(26)Tj
0 g
(].)Tj
1.7348 0 Td
(Individual)Tj
4.3654 0 Td
(patients)Tj
3.3675 0 Td
(may)Tj
1.9275 0 Td
(have)Tj
2.058 0 Td
(been)Tj
2.126 0 Td
(exposed)Tj
3.4412 0 Td
(to)Tj
1.0261 0 Td
(one)Tj
1.7008 0 Td
(or)Tj
1.0998 0 Td
(more)Tj
2.3414 0 Td
(of)Tj
1.0148 0 Td
(the)Tj
1.4684 0 Td
(prescribing)Tj
4.7395 0 Td
(risks)Tj
-34.1459 -1.2982 Td
(and)Tj
1.7291 0 Td
(the)Tj
1.4683 0 Td
(combined)Tj
4.2463 0 Td
(measure)Tj
3.5773 0 Td
(gave)Tj
2.0012 0 Td
(an)Tj
1.2019 0 Td
(overall)Tj
2.9027 0 Td
(signal)Tj
2.5398 0 Td
(of)Tj
1.0148 0 Td
(practice)Tj
3.3789 0 Td
(risky)Tj
2.1713 0 Td
(prescribing.)Tj
4.9663 0 Td
(This)Tj
1.9899 0 Td
(latter)Tj
2.2904 0 Td
(indi-)Tj
-35.4782 -1.2983 Td
(cator)Tj
2.2506 0 Td
(was)Tj
1.7008 0 Td
(scored)Tj
2.8346 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4684 0 Td
(opposing)Tj
3.9117 0 Td
(direction)Tj
3.8495 0 Td
(to)Tj
1.0261 0 Td
(the)Tj
1.4683 0 Td
(others:)Tj
2.9367 0 Td
(lower)Tj
2.4548 0 Td
(values)Tj
2.6646 0 Td
(here)Tj
1.9672 0 Td
(generally)Tj
3.8324 0 Td
(suggest)Tj
-33.4032 -1.3039 Td
(safer,)Tj
2.3243 0 Td
(more)Tj
2.3414 0 Td
(desirable)Tj
3.7814 0 Td
(practice,)Tj
3.6 0 Td
(while)Tj
2.3698 0 Td
(higher)Tj
2.8006 0 Td
(values)Tj
2.6702 0 Td
(were)Tj
2.1203 0 Td
(desirable)Tj
3.7814 0 Td
(on)Tj
1.2756 0 Td
(all)Tj
1.1452 0 Td
(other)Tj
2.3527 0 Td
(indicators.)Tj
4.4504 0 Td
(When)Tj
-35.0133 -1.2983 Td
(producing)Tj
4.3766 0 Td
(combined)Tj
4.2406 0 Td
(indicators,)Tj
4.4504 0 Td
(all)Tj
1.1452 0 Td
(indicators)Tj
4.2292 0 Td
(were)Tj
2.1203 0 Td
(equally)Tj
3.0614 0 Td
(weighted)Tj
3.8381 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4683 0 Td
(basis)Tj
2.1487 0 Td
(that)Tj
1.7801 0 Td
(they)Tj
1.9219 0 Td
(had)Tj
-36.0564 -1.2983 Td
(all)Tj
1.1451 0 Td
(been)Tj
2.1203 0 Td
(through)Tj
3.4469 0 Td
(a)Tj
0.652 0 Td
(priority-setting)Tj
6.2872 0 Td
(process)Tj
3.1861 0 Td
([)Tj
0.83 0.64 0.02 0 k
(8)Tj
0 g
(])Tj
1.3777 0 Td
(and)Tj
1.7291 0 Td
(were)Tj
2.1203 0 Td
(considered)Tj
4.6034 0 Td
(clinically)Tj
3.7758 0 Td
(important.)Tj
-29.2477 -1.3039 Td
(Independent)Tj
5.3517 0 Td
(variables)Tj
3.7191 0 Td
(included)Tj
3.7077 0 Td
(patient-)Tj
3.3618 0 Td
(and)Tj
1.7292 0 Td
(practice-level)Tj
5.5218 0 Td
(characteristics)Tj
5.9074 0 Td
(we)Tj
1.3266 0 Td
(hypothesised)Tj
-31.8215 -1.2982 Td
(or)Tj
1.0941 0 Td
(recognised)Tj
4.5411 0 Td
(from)Tj
2.2053 0 Td
(earlier)Tj
2.7553 0 Td
(work)Tj
2.279 0 Td
(to)Tj
1.0262 0 Td
(be)Tj
1.1508 0 Td
(associated)Tj
4.2576 0 Td
(with)Tj
1.9956 0 Td
(practice)Tj
3.3789 0 Td
(performance)Tj
5.3461 0 Td
([)Tj
0.83 0.64 0.02 0 k
(27)Tj
0 g
(,)Tj
0.83 0.64 0.02 0 k
1.7405 0 Td
(28)Tj
0 g
(].)Tj
1.7348 0 Td
(At)Tj
1.2018 0 Td
(the)Tj
-34.7071 -1.2983 Td
(patient)Tj
3.0047 0 Td
(level)Tj
2.0182 0 Td
(we)Tj
1.3266 0 Td
(examined)Tj
4.1272 0 Td
(demographic)Tj
5.5049 0 Td
(\(age,)Tj
2.1089 0 Td
(gender)Tj
2.9764 0 Td
(and)Tj
1.7348 0 Td
(ethnicity\),)Tj
4.2916 0 Td
(and)Tj
1.7291 0 Td
(illness)Tj
2.6759 0 Td
(variables.)Tj
3.9458 0 Td
(Ill-)Tj
-35.4441 -1.3039 Td
(ness)Tj
1.9105 0 Td
(was)Tj
1.7008 0 Td
(assessed)Tj
3.4752 0 Td
(by)Tj
1.1792 0 Td
(a)Tj
0.652 0 Td
(measure)Tj
3.583 0 Td
(of)Tj
1.0148 0 Td
(comorbidity:)Tj
5.3971 0 Td
(the)Tj
1.4683 0 Td
(number)Tj
3.4186 0 Td
(of)Tj
1.0148 0 Td
(QOF)Tj
2.2393 0 Td
(disease)Tj
3.0161 0 Td
(registers)Tj
3.5659 0 Td
(on)Tj
1.2756 0 Td
(which)Tj
-34.9112 -1.2983 Td
(a)Tj
0.6519 0 Td
(patient)Tj
3.0104 0 Td
(appeared.)Tj
-2.4661 -1.2983 Td
(Practice-level)Tj
5.5672 0 Td
(variables)Tj
3.719 0 Td
(comprised)Tj
4.439 0 Td
(the)Tj
1.4684 0 Td
(number)Tj
3.4185 0 Td
(of)Tj
1.0148 0 Td
(practice)Tj
3.3789 0 Td
(partners)Tj
3.5433 0 Td
(\(which)Tj
2.9934 0 Td
(served)Tj
2.7779 0 Td
(as)Tj
1.0148 0 Td
(a)Tj
0.6576 0 Td
(proxy)Tj
-35.189 -1.2982 Td
(of)Tj
1.0147 0 Td
(practice)Tj
3.3789 0 Td
(size\),)Tj
2.2507 0 Td
(the)Tj
1.4684 0 Td
(number)Tj
3.4185 0 Td
(of)Tj
1.0148 0 Td
(salaried)Tj
3.2825 0 Td
(family)Tj
2.7326 0 Td
(physicians,)Tj
4.6034 0 Td
(and)Tj
1.7292 0 Td
(training)Tj
3.4242 0 Td
(statusall)Tj
4.3483 0 Td
(recorded)Tj
3.7984 0 Td
(as)Tj
-36.4646 -1.3039 Td
(at)Tj
0.9524 0 Td
(April)Tj
2.3074 0 Td
(2014.)Tj
2.347 0 Td
(We)Tj
1.6101 0 Td
(used)Tj
2.058 0 Td
(practice-level)Tj
5.5218 0 Td
(Index)Tj
2.5285 0 Td
(of)Tj
1.0148 0 Td
(Multiple)Tj
3.634 0 Td
(Deprivation)Tj
5.0456 0 Td
(\(IMD\))Tj
2.8687 0 Td
(scores.)Tj
2.897 0 Td
(This)Tj
1.9842 0 Td
(mea-)Tj
-34.7695 -1.2983 Td
(sures)Tj
2.262 0 Td
(area)Tj
1.8822 0 Td
(deprivation)Tj
4.8359 0 Td
(and)Tj
1.7347 0 Td
(is)Tj
0.8448 0 Td
(determined)Tj
4.8528 0 Td
(for)Tj
1.3833 0 Td
(each)Tj
2.0296 0 Td
(patient)Tj
3.0104 0 Td
(on)Tj
1.2756 0 Td
(the)Tj
1.4683 0 Td
(list,)Tj
1.6158 0 Td
(where)Tj
2.6532 0 Td
(available,)Tj
3.8891 0 Td
(and)Tj
1.7291 0 Td
(then)Tj
-35.4668 -1.2983 Td
(averaged)Tj
3.753 0 Td
(over)Tj
1.9786 0 Td
(the)Tj
1.4683 0 Td
(practice.)Tj
3.6 0 Td
(Overall)Tj
3.1464 0 Td
(achievement)Tj
5.2611 0 Td
(in)Tj
1.0375 0 Td
(the)Tj
1.4683 0 Td
(QOF)Tj
2.245 0 Td
(clinical)Tj
3.0728 0 Td
(domain)Tj
3.3278 0 Td
(\(201213\))Tj
4.269 0 Td
(was)Tj
-34.6278 -1.3039 Td
(used)Tj
2.0579 0 Td
(as)Tj
1.0148 0 Td
(a)Tj
0.652 0 Td
(proxy)Tj
2.5398 0 Td
(measure)Tj
3.5773 0 Td
(for)Tj
1.3889 0 Td
(overall)Tj
2.9027 0 Td
(quality)Tj
2.9537 0 Td
(of)Tj
1.0148 0 Td
(care.)Tj
2.0976 0 Td
(By)Tj
1.2529 0 Td
(providing)Tj
4.1499 0 Td
(a)Tj
0.652 0 Td
(wide-ranging)Tj
5.5729 0 Td
(and)Tj
1.7291 0 Td
(objective)Tj
-33.5563 -1.2982 Td
(measure)Tj
3.5773 0 Td
(of)Tj
1.0147 0 Td
(items)Tj
2.3925 0 Td
(recommended)Tj
6.0377 0 Td
(by)Tj
1.1792 0 Td
(professionals)Tj
5.4142 0 Td
(and)Tj
1.7291 0 Td
(patients,)Tj
3.5943 0 Td
(it)Tj
0.7824 0 Td
(is)Tj
0.8504 0 Td
(generally)Tj
3.8324 0 Td
(accepted)Tj
3.6907 0 Td
(that)Tj
1.7801 0 Td
(the)Tj
-35.875 -1.2983 Td
(QOF)Tj
2.2393 0 Td
(offers)Tj
2.4605 0 Td
(a)Tj
0.6519 0 Td
(good)Tj
2.228 0 Td
(snapshot)Tj
3.7758 0 Td
(of)Tj
1.0148 0 Td
(quality)Tj
2.9536 0 Td
([)Tj
0.83 0.64 0.02 0 k
(29)Tj
0 g
(].)Tj
2.075 0 Td
(Practice)Tj
3.4242 0 Td
(prescribing)Tj
4.7395 0 Td
(costs)Tj
2.1713 0 Td
(over)Tj
1.9786 0 Td
(the)Tj
1.4684 0 Td
(period)Tj
2.8346 0 Td
(were)Tj
-34.0155 -1.3039 Td
(also)Tj
1.7688 0 Td
(collected,)Tj
3.9628 0 Td
(measured)Tj
4.1102 0 Td
(as)Tj
1.0148 0 Td
(cost)Tj
1.8085 0 Td
(per)Tj
1.5307 0 Td
(Age,)Tj
2.0182 0 Td
(Sex)Tj
1.5874 0 Td
(and)Tj
1.7291 0 Td
(Temporary)Tj
4.7282 0 Td
(Resident)Tj
3.6907 0 Td
(Prescribing)Tj
4.7848 0 Td
(Unit)Tj
-32.7342 -1.2983 Td
(\(ASTRO-PU\))Tj
5.6862 0 Td
(over)Tj
1.9729 0 Td
(the)Tj
1.4684 0 Td
(year)Tj
1.9048 0 Td
(201213.)Tj
-9.8361 -1.2983 Td
(Two)Tj
2.0239 0 Td
(further)Tj
3.0274 0 Td
(practice-level)Tj
5.5275 0 Td
(variables)Tj
3.7134 0 Td
(were)Tj
2.1259 0 Td
(included:)Tj
3.9345 0 Td
(patient)Tj
3.0104 0 Td
(satisfaction)Tj
4.7054 0 Td
(\(the)Tj
1.8085 0 Td
(proportion)Tj
-31.0731 -1.3039 Td
(reporting)Tj
3.9911 0 Td
(that)Tj
1.7745 0 Td
(they)Tj
1.9275 0 Td
(would)Tj
2.7099 0 Td
(recommend)Tj
5.0854 0 Td
(the)Tj
1.4683 0 Td
(practice)Tj
3.3789 0 Td
(to)Tj
1.0261 0 Td
(others\))Tj
3.0501 0 Td
(and)Tj
1.7291 0 Td
(practice)Tj
3.3789 0 Td
(accessibility)Tj
4.9549 0 Td
(\(the)Tj
-34.4747 -1.2982 Td
(proportion)Tj
4.6317 0 Td
(reporting)Tj
3.9912 0 Td
(that)Tj
1.7745 0 Td
(they)Tj
1.9275 0 Td
(were)Tj
2.1203 0 Td
(able)Tj
1.8312 0 Td
(to)Tj
1.0261 0 Td
(speak)Tj
2.4491 0 Td
(with)Tj
2.0013 0 Td
(a)Tj
0.6519 0 Td
(family)Tj
2.727 0 Td
(physician/nurse)Tj
6.5876 0 Td
(within)Tj
2.812 0 Td
(48)Tj
-34.5314 -1.2983 Td
(hours)Tj
2.5114 0 Td
(of)Tj
1.0148 0 Td
(approach\).)Tj
ET
Q
q
1 j
1 J
0 w
11.9999 0 0 11.9999 200.0125 164.9763 cm
BT
/F0 1 Tf
1 TL
-0.0033 Tc
0 0 Td
(Data)Tj
2.3102 0 Td
(sources)Tj
ET
Q
q
1 j
1 J
0 w
10 0 0 10 200.0125 148.0251 cm
BT
/F5 1 Tf
1 TL
-0.004 Tc
0 0 Td
(The)Tj
1.7801 0 Td
(NHS)Tj
2.1997 0 Td
(Yorkshire)Tj
4.1782 0 Td
(and)Tj
1.7291 0 Td
(Humber)Tj
3.6397 0 Td
(Commissioning)Tj
6.6217 0 Td
(Support)Tj
3.4356 0 Td
(Unit)Tj
2.0692 0 Td
(remotely)Tj
3.7644 0 Td
(extracted)Tj
3.8835 0 Td
(data)Tj
1.9162 0 Td
(from)Tj
-35.2174 -1.3039 Td
(participating)Tj
5.3291 0 Td
(practices.)Tj
3.9628 0 Td
(The)Tj
1.7858 0 Td
(Unit)Tj
2.0693 0 Td
(also)Tj
1.7688 0 Td
(supplied)Tj
3.6056 0 Td
(information)Tj
5.074 0 Td
(on)Tj
1.2756 0 Td
(general)Tj
3.1351 0 Td
(practice)Tj
3.3788 0 Td
(characteristics)Tj
-31.3849 -1.2982 Td
(and)Tj
1.7291 0 Td
(practice)Tj
3.3788 0 Td
(prescribing)Tj
4.7452 0 Td
(data.)Tj
2.1373 0 Td
(Patient)Tj
3.0501 0 Td
(data)Tj
1.9105 0 Td
(were)Tj
2.126 0 Td
(anonymised)Tj
5.108 0 Td
(before)Tj
2.7439 0 Td
(transfer)Tj
3.3165 0 Td
(to)Tj
1.0205 0 Td
(the)Tj
1.474 0 Td
(research)Tj
-32.7399 -1.2983 Td
(team.)Tj
1.1962 -1.3039 Td
(Patient)Tj
3.05 0 Td
(satisfaction)Tj
4.7112 0 Td
(and)Tj
1.7291 0 Td
(practice)Tj
3.3789 0 Td
(accessibility)Tj
4.9549 0 Td
(data)Tj
1.9105 0 Td
(were)Tj
2.126 0 Td
(obtained)Tj
3.7304 0 Td
(from)Tj
2.2053 0 Td
(the)Tj
1.4684 0 Td
(publicly)Tj
3.4129 0 Td
(available)Tj
-33.8738 -1.2983 Td
(National)Tj
3.6906 0 Td
(General)Tj
3.3846 0 Td
(Practice)Tj
3.4185 0 Td
(Profiles)Tj
3.2429 0 Td
([)Tj
0.83 0.64 0.02 0 k
(30)Tj
0 g
(].)Tj
ET
Q
q
1 j
1 J
0 w
576 737.1 m
36 737.1 l
36 737.6 l
576 737.6 l
f*
36 741.2598 107.1496 23.6976 re
W* n
q
107.0929 0 0 23.6409 36 741.3165 cm
q
/I0 Do
Q
Q
Q
q
0 0 612 792 re
W* n
1 j
1 J
0 w
7.9999 0 0 7.9999 378.2551 745.7952 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(Variations)Tj
4.5779 0 Td
(in)Tj
0.978 0 Td
(achievement)Tj
5.7969 0 Td
(of)Tj
1.0417 0 Td
(indicator)Tj
3.6993 0 Td
(s)Tj
0.7157 0 Td
(in)Tj
0.978 0 Td
(general)Tj
3.4866 0 Td
(practice)Tj
ET
Q
q
1 j
1 J
0 w
36 48.0002 m
576 48.0002 l
576 47.5002 l
36 47.5002 l
f*
0.83 0.64 0.02 0 k
81.5811 34.9228 m
237.8835 34.9228 l
h
f*
0 g
7.9999 0 0 7.9999 36 36 cm
BT
/F0 1 Tf
1 TL
-0.005 Tc
0 0 Td
(PLOS)Tj
2.8559 0 Td
(ONE)Tj
2.3669 0 Td
(|)Tj
0.83 0.64 0.02 0 k
0.4748 0 Td
(https://doi.or)Tj
5.4142 0 Td
(g/10.137)Tj
3.8198 0 Td
(1/journal.po)Tj
5.1236 0 Td
(ne.01779)Tj
4.089 0 Td
(49)Tj
0 g
2.0906 0 Td
(July)Tj
1.9701 0 Td
(13,)Tj
1.5874 0 Td
(2017)Tj
35.3483 0 Td
(5)Tj
0.7654 0 Td
(/)Tj
ET
endstream
endobj
113 0 obj
<>stream
endstream
endobj
114 0 obj
<>stream
endstream
endobj
115 0 obj
<>stream
endstream
endobj
116 0 obj
<>stream
endstream
endobj
117 0 obj
<>stream
endstream
endobj
118 0 obj
<>stream
endstream
endobj
119 0 obj
<>stream
endstream
endobj
120 0 obj
<>stream
BT
66.402 0 Td
(18)Tj
ET
Q
endstream
endobj
121 0 obj
<>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 11 0 R/Annots 123 0 R/Contents 124 0 R/TrimBox[0 0 612 792]>>
endobj
122 0 obj
<>
endobj
125 0 obj
<>
endobj
126 0 obj
<>stream
%!PS-AdobeFont-1.0
11 dict begin
/FontName /TeX_CM_Maths_Italic def
/FontType 1 def
/FontBBox {-31 -239 1041 750} readonly def
/FontMatrix [0.001 0 0 0.001 0 0] readonly def
/PaintType 0 def
/FontInfo 8 dict dup begin
/FullName (TeX_CM_Maths_Italic) readonly def
/BaseFontName (TeX_CM_Maths_Italic) def
end def
/Encoding 256 array
0 1 255 {1 index exch /.notdef put} for
dup 0 /C0 put
dup 1 /C1 put
dup 2 /C2 put
dup 3 /C3 put
dup 4 /C4 put
dup 5 /C5 put
dup 6 /C6 put
dup 7 /C7 put
dup 8 /C8 put
dup 9 /C9 put
dup 10 /C10 put
dup 11 /C11 put
dup 12 /C12 put
dup 13 /C13 put
dup 14 /C14 put
dup 15 /C15 put
dup 16 /C16 put
dup 17 /C17 put
dup 18 /C18 put
dup 19 /C19 put
dup 20 /C20 put
dup 21 /C21 put
dup 22 /C22 put
dup 23 /C23 put
dup 24 /C24 put
dup 25 /C25 put
dup 26 /C26 put
dup 27 /C27 put
dup 28 /C28 put
dup 29 /C29 put
dup 30 /C30 put
dup 31 /C31 put
dup 32 /space put
dup 33 /exclam put
dup 34 /quotedbl put
dup 35 /numbersign put
dup 36 /dollar put
dup 37 /percent put
dup 38 /ampersand put
dup 39 /quoteright put
dup 40 /parenleft put
dup 41 /parenright put
dup 42 /asterisk put
dup 43 /plus put
dup 44 /comma put
dup 45 /hyphen put
dup 46 /period put
dup 47 /slash put
dup 48 /zero put
dup 49 /one put
dup 50 /two put
dup 51 /three put
dup 52 /four put
dup 53 /five put
dup 54 /six put
dup 55 /seven put
dup 56 /eight put
dup 57 /nine put
dup 58 /colon put
dup 59 /semicolon put
dup 60 /less put
dup 61 /equal put
dup 62 /greater put
dup 63 /question put
dup 64 /at put
dup 65 /A put
dup 66 /B put
dup 67 /C put
dup 68 /D put
dup 69 /E put
dup 70 /F put
dup 71 /G put
dup 72 /H put
dup 73 /I put
dup 74 /J put
dup 75 /K put
dup 76 /L put
dup 77 /M put
dup 78 /N put
dup 79 /O put
dup 80 /P put
dup 81 /Q put
dup 82 /R put
dup 83 /S put
dup 84 /T put
dup 85 /U put
dup 86 /V put
dup 87 /W put
dup 88 /X put
dup 89 /Y put
dup 90 /Z put
dup 91 /bracketleft put
dup 92 /backslash put
dup 93 /bracketright put
dup 94 /asciicircum put
dup 95 /underscore put
dup 96 /quoteleft put
dup 97 /a put
dup 98 /b put
dup 99 /c put
dup 100 /d put
dup 101 /e put
dup 102 /f put
dup 103 /g put
dup 104 /h put
dup 105 /i put
dup 106 /j put
dup 107 /k put
dup 108 /l put
dup 109 /m put
dup 110 /n put
dup 111 /o put
dup 112 /p put
dup 113 /q put
dup 114 /r put
dup 115 /s put
dup 116 /t put
dup 117 /u put
dup 118 /v put
dup 119 /w put
dup 120 /x put
dup 121 /y put
dup 122 /z put
dup 123 /braceleft put
dup 124 /bar put
dup 125 /braceright put
dup 126 /asciitilde put
dup 127 /Euro put
readonly def
currentdict end
currentfile eexec
M#1H5 J6o\&rtS(#v\0\V7Fe༙OYx5-cY9^%Y6
(efIOldN"wȰ;)UƽoFg/rvV$JS8_oc@
o9-eGJp}[Do]mN=4*{ܯq=eU^t6¤.vA2*Sr 2@Y0}Rcx,TX|ZP
;o<[1?
T<=qo:-62/]8~i wX?wJ`lLkI@EjYׅq5ڧHtvc6i 0M]YUN;M]ť0]z[{s1uO[6be#9k~d/YpMA.=뤎P\|W#?W$iz81ZL
Ңri^?WP]X A.@
z[
75y6k .U*3}hA\t&HW!Q
=+Г A 5