Evaluation of Imaging Ordering by General Practitioners in Australia 2002-03 to 2011-12

General Practice Series No. 35

Helena Britt, Graeme C. Miller, Lisa Valenti, Joan Henderson, Julie Gordon, Allan J. Pollack, Clare Bayram, and Carmen Zhang

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Format: paperback
192 pages
ISBN: 9781743324134

Publication: 01 Jun 2014
Series: General Practice Series
Publisher: Sydney University Press

This book reports changes in GP ordering of imaging tests in Australia from 2002–3 to 2011–2, and evaluates alignment between guidelines and recent GP test ordering for selected problems.

Over the decade, 9,802 GPs participated in BEACH, providing details of 980,200 GP–patient encounters. The likelihood of GPs ordering imaging in the management of a problem increased over time. In recent practice, at least one imaging test was ordered at 9 per cent of encounters, at a rate of 10 imaging tests per 100 encounters.

Diagnostic radiology was the most commonly ordered type of imaging test, but the order rate decreased over time, with a shift toward orders for ultrasound, CT and MRI, which all significantly increased.

Eight selected problems accounted for one-third of all imaging orders. Imaging ordering behaviour suggests broad compliance with published guidelines in the management of osteoarthritis, shoulder problems, bursitis/tendonitis/synovitis, abdominal pain and other musculoskeletal injuries. Current ordering patterns for knee problems and some sprains/strains have potential for improvement. The ordering pattern for new presentations of back problems was inconsistent with all established guidelines for management of back problems.

Allan J. Pollack is a research analyst at the Family Medicine Research Centre at the University of Sydney.

Carmen Zhang is a research officer at the Family Medicine Research Centre at the University of Sydney.

Clare Bayram is a research fellow at the Family Medical Research Centre at the University of Sydney, and project manager of the BEACH program.

Graeme Miller is an associate professor and Medical Director of the Family Medicine Research Centre at the University of Sydney.

Helena Britt is a professor of primary care research at the University of Sydney.

Joan Henderson is the Deputy Director of the Family Medicine Research Centre at the University of Sydney.

Julie Gordon (née O'Halloran) is a research fellow at the Family Medical Research Centre at the University of Sydney.

Lisa Valenti is a senior research analyst for the Family Medicine Research Centre at the University of Sydney.

Acknowledgments
List of tables
List of figures and boxes
Summary

Section 1: background, method and overview of GPs’ imaging ordering
1. Introduction
2. Methods
3. The BEACH database
4. Imaging test ordering by GPs

Section 2: problem-based investigation
5. Back problems
6. Osteoarthritis problems
7. Shoulder problems
8. Sprains and strains
9. Bursitis/tendonitis/synovitis
10. Abdominal pain problems
11. Knee problems
12. Other musculoskeletal injuries

Section 3: test-based investigation
13. Problems for which diagnostic radiology, ultrasound, CT scan and MRI were ordered

References
Abbreviations
Symbols
Glossary
Appendix 1: example of a 2011–12 recording form
Appendix 2: GP characteristics questionnaire, 2011–12
Appendix 3: patient information card, 2011–12
Appendix 4: initial results of analyses of the BEACH data by year, from 2002–03 to 2011–12 inclusive
Appendix 5: code groups from ICPC-2 and ICPC-2 PLUS