Direct access to magnetic resonance imaging improved orthopaedic knee referrals in the Netherlands
| Autor: | Paul R Algra, Hans F Berg, Leandra J M Boonman-de Winter, Matthijs Vermeulen |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Referral General Practice Knee Injuries Knee Joint 030218 nuclear medicine & medical imaging Secondary care 03 medical and health sciences 0302 clinical medicine medicine Humans Prospective Studies 030212 general & internal medicine Prospective cohort study Referral and Consultation Aged Netherlands medicine.diagnostic_test business.industry Magnetic resonance imaging Evidence-based medicine Middle Aged Magnetic Resonance Imaging Logistic Models Orthopedics Orthopedic surgery Physical therapy Female Family Practice business Knee injuries |
| Zdroj: | Family Practice. 33:482-487 |
| ISSN: | 1460-2229 0263-2136 |
| DOI: | 10.1093/fampra/cmw035 |
| Popis: | BACKGROUND The use of magnetic resonance imaging (MRI) in primary care is under debate, and the majority of GPs have no experience with MRI. OBJECTIVES To examine for which patients with knee injury an MRI is ordered and does direct access to MRI in primary care influence the GP referral to an orthopaedic surgeon? METHODS Consecutive patients with knee injury who underwent an MRI examination ordered by their GP were included. On the application form for MRI, the GPs indicated their referral intention in advance, as if MRI had not been available. Six months after the MRI scan, written interviews with the GPs were used to collect data on referrals and orthopaedic intervention. The number of patients finally referred to an orthopaedic surgeon in secondary care after MRI was compared with the number of intended referrals. RESULTS Of the 588 included, GPs referred fewer patients to the orthopaedic surgeon after receiving the MRI results than they would have done prior to MRI (60% versus 82.8%, P < 0.0001). The reduction was 16.1% for patients older than 50 years and 28.1% for patients younger than 50 years. Orthopaedic intervention was performed in 62.9% of all referred patients. Of the 101 patients whom the GP did not intend to refer prior to MRI, 48 were referred to an orthopaedic surgeon based on the MRI findings. CONCLUSION In patients with knee injury, direct access to MRI of the knee in a primary care setting significantly reduced referrals to an orthopaedic surgeon. LEVEL OF EVIDENCE Three prospective cohort. |
| Databáze: | OpenAIRE |
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