BMJ. 1993 Jan 9;306(6870):110-1. doi: 10.1136/bmj.306.6870.110.
To measure the effect on general practitioner referrals for radiography of introducing guidelines of good practice together with monitoring and peer review.
Collection of referral data during 1 January 1989 to 31 December 1990. Guidelines were introduced on 1 January 1990.
Open access radiology services provided by one non-teaching district in England.
144614 registered patients from 22 practices.
Number of referrals per 1000 registered patients for radiography of the chest, skull, spine, abdomen, limbs, and joints and for barium investigation and excretion urography.
Overall referrals fell from 88.4/1000 registered patients to 77.2/1000 after the guidelines were introduced. The commonest reasons for referral were for examination of the chest, spine, and limbs and joints and referrals for these fell by 9.4%, 17.5%, and 13.5% respectively. Referrals for skull radiography fell by 30% (from 241 to 168).
By helping general practitioners to be more selective in their use of diagnostic radiology, the guidelines reduced the rate of referral and thus patients' exposure to radiation.
评估引入良好实践指南并进行监测和同行评审对全科医生转诊进行X光检查的影响。
收集1989年1月1日至1990年12月31日期间的转诊数据。指南于1990年1月1日引入。
英格兰一个非教学区提供的开放式放射科服务。
来自22家诊所的144614名注册患者。
每1000名注册患者中进行胸部、颅骨、脊柱、腹部、四肢和关节X光检查以及钡剂检查和排泄性尿路造影的转诊次数。
引入指南后，总体转诊率从每1000名注册患者88.4次降至77.2次。最常见的转诊原因是胸部、脊柱以及四肢和关节检查，这些方面的转诊分别下降了9.4%、17.5%和13.5%。颅骨X光检查的转诊次数下降了30%（从241次降至168次）。
通过帮助全科医生在使用诊断性放射学检查时更加具有选择性，这些指南降低了转诊率，从而减少了患者的辐射暴露。
