CoChat
Sign Up
Cited by 222Healthcare cost, quality, practicesRadiology practices and educationClinical practice guidelines implementation

The DOI matches its Crossref record; 29 of the 31 references it cites were found in a registry or an index.

Effect of audit and feedback, and reminder messages on primary-care radiology referrals: a randomised trial

Open access
Eccles, Martin, Steen, Nick, Grimshaw, Jeremy, Thomas, Lois, McNamee, Paul, Soutter, Jennifer, Wilsdon, John, Matowe, Lloyd, Needham, Gillian, Gilbert, Fiona, Bond, Senga·2001·The Lancet
DOI 10.1016/s0140-6736(00)04564-5
Open this paper in CoChat — free account

Abstract

Background Radiological tests are often used by general practitioners (GPs). These tests can be overused and contribute little to clinical management. We aimed to assess two methods of reducing GP requests for radiological tests in accordance with the UK Royal College of Radiologists' guidelines on lumbar spine and knee radiographs. Methods We assessed audit and feedback, and educational reminder messages in six radiology departments and 244 general practices that they served. The study was a before-and-after, pragmatic, cluster randomised controlled trial with a 232 factorial design. A random subset of GP patients' records were examined for concordance with the guidelines. The main outcome measure was number of radiograph requests per 1000 patients per year. Analysis was by intention to treat. Findings The effect of educational reminder messages (ie, the change in request rate after intervention) was an absolute change of -1.53 (95% CI -2.5 to -0.57) for lumbar spine and of -1.61 (-2.6 to -0.62) for knee radiographs, both relative reductions of about 20%. The effect of audit and feedback was an absolute change of -0.07 (-1.3 to 0.9) for lumbar spine of 0.04 (-0.95 to 1.03) for knee radiograph requests, both relative reductions of about 1%. Concordance between groups did not differ significantly. Interpretation 6-monthly feedback of audit data is ineffective but the routine attachment of educational reminder messages to radiographs is effective and does not affect quality of referrals. Any department of radiology that handles referrals from primary care could deliver this intervention to good effect.

Overview

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(00)04564-5

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Research works printed but not linked: 1

  1. 1994, Implementing clinical practice guidelines: can guidelines be used to improve clinical practice?, Effect Health Care, 8, 1

Cited by

Sorted by citations

See all 222

Related

See all

Metadata

Authors
Eccles, M., Steen, N., Grimshaw, J., Thomas, L., McNamee, P., Soutter, J., Wilsdon, J., Matowe, L., Needham, G., Gilbert, F., & Bond, S.
Affiliations
  • Newcastle University (GB)
  • University of Aberdeen (GB)
  • Newcastle upon Tyne Hospital (GB)
  • Aberdeen Royal Infirmary (GB)
Corresponding author
Eccles, Martin
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2001-05
Volume
357
Issue
9266
Pages
1406-1409
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(00)04564-5
OpenAlex
W2123697166
Cited by
222
References
31
Citations by year
2026: 4 · 2025: 4 · 2024: 6 · 2023: 10 · 2022: 10 · 2021: 7 · 2020: 18 · 2019: 8 · 2018: 13 · 2017: 3 · 2016: 12 · 2015: 11 · 2014: 7 · 2013: 11 · 2012: 6
FWCI
23.80
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • CLOK (University of Central Lancashire) (submittedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
Royal College of Radiologists
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
audit and feedback, lumbar spine radiographs, knee radiographs, guideline adherence, general practitioners, radiology department
MeSH terms
Adult, England, Family Practice, Feedback, Humans, Knee, Lumbar Vertebrae, Radiography, Referral and Consultation, Scotland, Cluster Analysis, Reminder Systems, Practice Guidelines as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review