General Practitioners' Use of Magnetic Resonance Imaging: An Open Randomized Trial Comparing Telephone and Written Requests and an Open Randomized Controlled Trial of Different Methods of Local Guideline Dissemination
AIM: To determine the impact and cost-effectiveness of telephone versus written access to magnetic resonance imaging (MRI), and of different strategies for disseminating locally produced guidelines, upon requests by general practitioners (GPs) for knee and lumbar spine investigation. MATERIAL AND ME...
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| Veröffentlicht in: | Clinical radiology 2002-05, Vol.57 (5), p.402-407 |
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| creator | Robling, Mike R. Houston, Helen L.A. Kinnersley, Paul Hourihan, Margaret D. Cohen, David R. Hale, Janine Hood, Kerry |
| description | AIM: To determine the impact and cost-effectiveness of telephone versus written access to magnetic resonance imaging (MRI), and of different strategies for disseminating locally produced guidelines, upon requests by general practitioners (GPs) for knee and lumbar spine investigation. MATERIAL AND METHODS: Two sequential pragmatic open cluster-randomized trials were conducted within 39 general practices. The outcome measure in each trial was concordance of request with local guidelines. Trial 1: practices requested MRI by telephone or in writing. Trial 2: all practices received guidelines, plus either: a practice-based seminar, practice-specific audit feedback, both seminar and feedback, or neither. RESULTS: A total of 414 requests were assessed in the two trials. Trial 1: telephone access cost £4.86 more per request but rates of concordant requests were equivalent (65%/64%: telephone/written). Trial 2: compared to the control group, costs per practice were £1911 higher in seminar group, £1543 higher in feedback group and £3578 higher for those receiving both. Concordance was greater following the intervention (74% vs 65%;P |
| doi_str_mv | 10.1053/crad.2001.0864 |
| format | Article |
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MATERIAL AND METHODS: Two sequential pragmatic open cluster-randomized trials were conducted within 39 general practices. The outcome measure in each trial was concordance of request with local guidelines. Trial 1: practices requested MRI by telephone or in writing. Trial 2: all practices received guidelines, plus either: a practice-based seminar, practice-specific audit feedback, both seminar and feedback, or neither. RESULTS: A total of 414 requests were assessed in the two trials. Trial 1: telephone access cost £4.86 more per request but rates of concordant requests were equivalent (65%/64%: telephone/written). Trial 2: compared to the control group, costs per practice were £1911 higher in seminar group, £1543 higher in feedback group and £3578 higher for those receiving both. Concordance was greater following the intervention (74% vs 65%;P<0.05), but there was no difference between the four study groups. CONCLUSIONS: Method of access did not affect concordance. Written access was more cost-effective. Seminars and feedback were no more effective in modifying practice than guidelines alone, which was thus the most cost-effective option. Robling, M.R. et al. (2002). Clinical Radiology57, 402–407.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1053/crad.2001.0864</identifier><identifier>PMID: 12014939</identifier><identifier>CODEN: CLRAAG</identifier><language>eng</language><publisher>Amsterdam: Elsevier Ltd</publisher><subject>Biological and medical sciences ; Chi-Square Distribution ; Cost-Benefit Analysis ; Education, Medical, Continuing ; Guideline Adherence ; Humans ; Information Services - economics ; Investigative techniques, diagnostic techniques (general aspects) ; Knee - pathology ; Lumbar Vertebrae - pathology ; magnetic resonance (MR), knee, spine, education ; Magnetic Resonance Imaging - economics ; Magnetic Resonance Imaging - utilization ; Medical sciences ; Osteoarticular system. Muscles ; Physicians, Family - education ; Practice Guidelines as Topic ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Referral and Consultation - economics ; Regression Analysis ; Telephone</subject><ispartof>Clinical radiology, 2002-05, Vol.57 (5), p.402-407</ispartof><rights>2002 The Royal College of Radiologists</rights><rights>2002 INIST-CNRS</rights><rights>Copyright 2002 The Royal College of Radiologists.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c370t-90478e1f1a1847fb1df60cd228493980f67889a4273155f69c1919cf616cd1e23</citedby><cites>FETCH-LOGICAL-c370t-90478e1f1a1847fb1df60cd228493980f67889a4273155f69c1919cf616cd1e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/crad.2001.0864$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13949068$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12014939$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Robling, Mike R.</creatorcontrib><creatorcontrib>Houston, Helen L.A.</creatorcontrib><creatorcontrib>Kinnersley, Paul</creatorcontrib><creatorcontrib>Hourihan, Margaret D.</creatorcontrib><creatorcontrib>Cohen, David R.</creatorcontrib><creatorcontrib>Hale, Janine</creatorcontrib><creatorcontrib>Hood, Kerry</creatorcontrib><title>General Practitioners' Use of Magnetic Resonance Imaging: An Open Randomized Trial Comparing Telephone and Written Requests and an Open Randomized Controlled Trial of Different Methods of Local Guideline Dissemination</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>AIM: To determine the impact and cost-effectiveness of telephone versus written access to magnetic resonance imaging (MRI), and of different strategies for disseminating locally produced guidelines, upon requests by general practitioners (GPs) for knee and lumbar spine investigation. MATERIAL AND METHODS: Two sequential pragmatic open cluster-randomized trials were conducted within 39 general practices. The outcome measure in each trial was concordance of request with local guidelines. Trial 1: practices requested MRI by telephone or in writing. Trial 2: all practices received guidelines, plus either: a practice-based seminar, practice-specific audit feedback, both seminar and feedback, or neither. RESULTS: A total of 414 requests were assessed in the two trials. Trial 1: telephone access cost £4.86 more per request but rates of concordant requests were equivalent (65%/64%: telephone/written). Trial 2: compared to the control group, costs per practice were £1911 higher in seminar group, £1543 higher in feedback group and £3578 higher for those receiving both. Concordance was greater following the intervention (74% vs 65%;P<0.05), but there was no difference between the four study groups. CONCLUSIONS: Method of access did not affect concordance. Written access was more cost-effective. Seminars and feedback were no more effective in modifying practice than guidelines alone, which was thus the most cost-effective option. Robling, M.R. et al. (2002). Clinical Radiology57, 402–407.</description><subject>Biological and medical sciences</subject><subject>Chi-Square Distribution</subject><subject>Cost-Benefit Analysis</subject><subject>Education, Medical, Continuing</subject><subject>Guideline Adherence</subject><subject>Humans</subject><subject>Information Services - economics</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Knee - pathology</subject><subject>Lumbar Vertebrae - pathology</subject><subject>magnetic resonance (MR), knee, spine, education</subject><subject>Magnetic Resonance Imaging - economics</subject><subject>Magnetic Resonance Imaging - utilization</subject><subject>Medical sciences</subject><subject>Osteoarticular system. Muscles</subject><subject>Physicians, Family - education</subject><subject>Practice Guidelines as Topic</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Referral and Consultation - economics</subject><subject>Regression Analysis</subject><subject>Telephone</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1vEzEQhlcIREPhyhH5ApwSbO_Ga3OrUgiVUhVVqeBmufY4Ndq1F9tBgn_Kv8FuInpAnKwZP_POx9s0LwleELxs3-mozIJiTBaYs-5RMyMtW84pFV8fNzOMsZgLyvBJ8yylbzXsaPe0OSEUk060Ytb8XoOHqAb0OSqdXXahhOktukmAgkWXauchO42uIQWvvAZ0Maqd87v36Myjqwk8ulbehNH9AoO20RWpVRgnFQuDtjDAdFckUWHQl-hyrgXwfQ8pp_uk-ldlFXyOYRj-CpZBzp21EMFndAn5LphUk5ugy-967wwMrjQ5dynB6Lyqazxvnlg1JHhxfE-bm48ftqtP883V-mJ1tpnrtsd5LnDXcyCWKMK73t4SYxnWhlJeD8SxZT3nQnW0b8lyaZnQRBChLSNMGwK0PW3eHHSnGO73kqNLGoZBeQj7JHvCuGh7XsDFAdQxpBTByim6UcWfkmBZzZTVTFnNlNXMUvDqqLy_HcE84Ef3CvD6CKhULmFjMcilB64VncCsduYHDsodfjiIMmkHxUzjIugsTXD_m-EP2pK-Cw</recordid><startdate>20020501</startdate><enddate>20020501</enddate><creator>Robling, Mike R.</creator><creator>Houston, Helen L.A.</creator><creator>Kinnersley, Paul</creator><creator>Hourihan, Margaret D.</creator><creator>Cohen, David R.</creator><creator>Hale, Janine</creator><creator>Hood, Kerry</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020501</creationdate><title>General Practitioners' Use of Magnetic Resonance Imaging: An Open Randomized Trial Comparing Telephone and Written Requests and an Open Randomized Controlled Trial of Different Methods of Local Guideline Dissemination</title><author>Robling, Mike R. ; Houston, Helen L.A. ; Kinnersley, Paul ; Hourihan, Margaret D. ; Cohen, David R. ; Hale, Janine ; Hood, Kerry</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c370t-90478e1f1a1847fb1df60cd228493980f67889a4273155f69c1919cf616cd1e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Biological and medical sciences</topic><topic>Chi-Square Distribution</topic><topic>Cost-Benefit Analysis</topic><topic>Education, Medical, Continuing</topic><topic>Guideline Adherence</topic><topic>Humans</topic><topic>Information Services - economics</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Knee - pathology</topic><topic>Lumbar Vertebrae - pathology</topic><topic>magnetic resonance (MR), knee, spine, education</topic><topic>Magnetic Resonance Imaging - economics</topic><topic>Magnetic Resonance Imaging - utilization</topic><topic>Medical sciences</topic><topic>Osteoarticular system. Muscles</topic><topic>Physicians, Family - education</topic><topic>Practice Guidelines as Topic</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Referral and Consultation - economics</topic><topic>Regression Analysis</topic><topic>Telephone</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Robling, Mike R.</creatorcontrib><creatorcontrib>Houston, Helen L.A.</creatorcontrib><creatorcontrib>Kinnersley, Paul</creatorcontrib><creatorcontrib>Hourihan, Margaret D.</creatorcontrib><creatorcontrib>Cohen, David R.</creatorcontrib><creatorcontrib>Hale, Janine</creatorcontrib><creatorcontrib>Hood, Kerry</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Robling, Mike R.</au><au>Houston, Helen L.A.</au><au>Kinnersley, Paul</au><au>Hourihan, Margaret D.</au><au>Cohen, David R.</au><au>Hale, Janine</au><au>Hood, Kerry</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>General Practitioners' Use of Magnetic Resonance Imaging: An Open Randomized Trial Comparing Telephone and Written Requests and an Open Randomized Controlled Trial of Different Methods of Local Guideline Dissemination</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2002-05-01</date><risdate>2002</risdate><volume>57</volume><issue>5</issue><spage>402</spage><epage>407</epage><pages>402-407</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><coden>CLRAAG</coden><abstract>AIM: To determine the impact and cost-effectiveness of telephone versus written access to magnetic resonance imaging (MRI), and of different strategies for disseminating locally produced guidelines, upon requests by general practitioners (GPs) for knee and lumbar spine investigation. MATERIAL AND METHODS: Two sequential pragmatic open cluster-randomized trials were conducted within 39 general practices. The outcome measure in each trial was concordance of request with local guidelines. Trial 1: practices requested MRI by telephone or in writing. Trial 2: all practices received guidelines, plus either: a practice-based seminar, practice-specific audit feedback, both seminar and feedback, or neither. RESULTS: A total of 414 requests were assessed in the two trials. Trial 1: telephone access cost £4.86 more per request but rates of concordant requests were equivalent (65%/64%: telephone/written). Trial 2: compared to the control group, costs per practice were £1911 higher in seminar group, £1543 higher in feedback group and £3578 higher for those receiving both. Concordance was greater following the intervention (74% vs 65%;P<0.05), but there was no difference between the four study groups. CONCLUSIONS: Method of access did not affect concordance. 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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Biological and medical sciences Chi-Square Distribution Cost-Benefit Analysis Education, Medical, Continuing Guideline Adherence Humans Information Services - economics Investigative techniques, diagnostic techniques (general aspects) Knee - pathology Lumbar Vertebrae - pathology magnetic resonance (MR), knee, spine, education Magnetic Resonance Imaging - economics Magnetic Resonance Imaging - utilization Medical sciences Osteoarticular system. Muscles Physicians, Family - education Practice Guidelines as Topic Radiodiagnosis. Nmr imagery. Nmr spectrometry Referral and Consultation - economics Regression Analysis Telephone |
| title | General Practitioners' Use of Magnetic Resonance Imaging: An Open Randomized Trial Comparing Telephone and Written Requests and an Open Randomized Controlled Trial of Different Methods of Local Guideline Dissemination |
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