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Cited by 39Clinical practice guidelines implementationHealthcare cost, quality, practicesRadiology practices and education

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

Robling, Mike R., Houston, Helen L.A., Kinnersley, Paul, Hourihan, Margaret D., Cohen, David R., Hale, Janine, Hood, Kerry·2002·Clinical Radiology
DOI 10.1053/crad.2001.0864
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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 pound4.86 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 pound1911 higher in seminar group, pound1543 higher in feedback group and pound3578 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.

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  • Robling 2002 found minimal difference in compliance with guidelines for MRI of the lumbar spine or knee (unadjusted RD = 4%, high risk of bias; no P value reported).

    “Robling 2002 found minimal difference in compliance with guidelines for MRI (Magnetic Resonance Imaging) of the lumbar spine or knee (unadjusted RD = 4%, high risk of bias; no P value reported).”

    From Audit and feedback: effects on professional practice and healthcare outcomes (2012) · cites this paper as Robling 2002

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Authors
Robling, M. R., Houston, H. L. A., Kinnersley, P., Hourihan, M. D., Cohen, D. R., Hale, J., & Hood, K.
Affiliations
  • University Hospital of Wales (GB)
  • University of Glamorgan (GB)
ORCID
Venue
Clinical Radiology
Publisher
Elsevier BV
Published
2002-05
Volume
57
Issue
5
Pages
402-407
ISSN
0009-9260 (ISSN-L)
DOI
10.1053/crad.2001.0864
OpenAlex
W2119383325
Cited by
39
References
18
Citations by year
2025: 3 · 2024: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 2 · 2012: 2
FWCI
0.35
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Clinical Radiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
Keywords
magnetic resonance imaging, general practitioners, guideline adherence, guideline dissemination, telephone access, knee imaging, lumbar spine imaging, audit and feedback, cost-effectiveness, primary care
MeSH terms
Cost-Benefit Analysis, Education, Medical, Continuing, Humans, Information Services, Knee, Lumbar Vertebrae, Magnetic Resonance Imaging, Physicians, Family, Referral and Consultation, Regression Analysis, Telephone, Chi-Square Distribution, Practice Guidelines as Topic, Guideline Adherence

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