The FHQ identified most informants with genetic risks that are appropriately addressed in primary care-those with a family history of premature coronary heart disease, those warranting specialist referral, and those who might appropriately be offered carrier testing. However, it was less effective in identifying those with a possible Mendelian disorder for whom more information was required.

Objectives To determine whether paperless medical records contained less information than paper based medical records and whether that information was harder to retrieve. Design Cross sectional study with review of medical records and interviews with general practitioners. Setting 25 general practices in Trent region. Participants 53 British general practitioners (25 using paperless records and 28 using paper based records) who each provided records of 10 consultations. Main outcome measures Content of a sample of records and doctor recall of consultations for which paperless or paper based records had been made.

Short-term psychological distress due to the family history screening questionnaire was identified but did not persist.

Most of the variation in the number of safety practices is not explained by socio-demographic characteristics and further work is required to examine other possible determinants of safe practice.

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Objective-The aim of this study was to investigate the validity of self reported safety behaviours as a proxy for injuries in unintentional injuries research. Setting-The study population comprised parents and guardians of children aged 3-12 months in 18 general practices throughout Nottingham (n=764) who responded to a questionnaire on safety practices. Method-Injury data were collected by searching the primary and secondary care records of each child in the study. Safety behaviour was measured by computing a safety practices score from self reported safety practices for each respondent to a postal baseline questionnaire survey of safety behaviours. The score was used to classify families into low, medium, and high risk of injury occurrence. Two further scores were calculated, firstly for those safety practices which required obtaining an item of safety equipment, and secondly those safety practices requiring behavioural change without cost implications. Results-High risk families were no more likely than low risk families to sustain an injury (odds ratio (OR) 1.08; 95% confidence interval 0.65 to 1.79). Medium risk families were also no more likely than low risk families to have a medically attended injury (OR 1.09; 0.73 to 1.61) suggesting no association between safety score and future medically attended injury. Similarly, compared to low risk families, medium risk (OR 0.93; 0.33 to 2.61) and high risk (OR 0.46; 0.08 to 2.43) families were no more likely to have a child admitted to hospital with an injury. There was no correlation between the total number of injuries sustained during the study period and the baseline safety practices score (Spearman's rho = 0.004; p=0.917). Subgroup analyses for safety behaviours requiring passive and active safety measures did not reveal significant associations with injury outcomes. Conclusion-Self reported safety behaviours do not appear to be good predictors of childhood unintentional injuries. Further research is required to ascertain valid proxy outcome measures for injury research.

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