Ciblis A S, Butler M-L, Bokde A L W, Mullins P G, McNulty J P
UCD School of Medicine and Medical Science, Diagnostic Imaging, Room 223, Health Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.
Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
Ir J Med Sci. 2016 Aug;185(3):597-602. doi: 10.1007/s11845-015-1315-4. Epub 2015 Jun 6.
More than 48,000 people in Ireland are living with dementia, and the number is likely to rise to 130,000 by 2041. Dementia frequently remains undiagnosed, depriving many of early interventions and the opportunity to plan for the future. Neuroimaging is helpful in the diagnosis of dementia, yet it is often insufficiently utilised. General practitioners (GPs) often decide which patients should be referred on for specialist assessment and as such play a crucial role in dementia diagnosis.
To establish the accessibility of neuroimaging in dementia by GPs, current referral patterns, confidence in referral and opinions on radiology reports.
The research design was a postal survey among GPs in single and group practices in urban, rural and semi-rural areas in the east and southeast of Ireland. GPs were identified from the Irish Medical Directory and posted individual anonymous questionnaires.
A third of participants reported that they had no direct access to neuroimaging. Access differed between public and private patients. GPs primarily referred to computed tomography and magnetic resonance imaging, but only 14.6 % based these referrals on published guidelines. A total of 47.8 % of participants were not very confident in their ability to choose the most appropriate modality.
Access to neuroimaging investigations for suspected cases of dementia varies between locations and public and private systems. To improve diagnostic rates and ensure appropriate utilisation of imaging resources, GPs require access to clinical and referral guidelines to ensure appropriate use of neuroimaging and the best possible patient outcomes.
爱尔兰有超过48000人患有痴呆症，到2041年这一数字可能会升至130000人。痴呆症常常未被诊断出来，使许多人无法获得早期干预以及规划未来的机会。神经影像学有助于痴呆症的诊断，但它的利用常常不足。全科医生（GPs）通常决定哪些患者应被转诊以进行专科评估，因此在痴呆症诊断中起着关键作用。
确定全科医生对痴呆症患者进行神经影像学检查的可及性、当前的转诊模式、转诊信心以及对放射学报告的看法。
研究设计为对爱尔兰东部和东南部城市、农村及半农村地区单人执业和团体执业的全科医生进行邮寄调查。从爱尔兰医学名录中确定全科医生，并邮寄个人匿名问卷。
三分之一的参与者报告称他们无法直接进行神经影像学检查。公立和私立患者的可及性存在差异。全科医生主要转诊进行计算机断层扫描和磁共振成像，但只有14.6%的转诊是基于已发表的指南。共有47.8%的参与者对自己选择最合适检查方式的能力不太自信。
对于疑似痴呆症病例，神经影像学检查的可及性在不同地点以及公立和私立系统之间存在差异。为提高诊断率并确保影像资源的合理利用，全科医生需要获取临床和转诊指南，以确保神经影像学的合理使用并实现最佳的患者治疗效果。
