To evaluate how referrals from Norwegian general practitioners for plain radiography of the lumbosacral spine conform to clinical recommendations, and whether non-conforming referrals yield important findings.
The clinical information reported in referral letters of 323 patients was compared with recommendations given in a Norwegian and in a British « guide ».
Additional clinical data were obtained by interviewing 100 of the patients.
Using all available information, a new comparison was performed.
Radiological findings were obtained from the routine reports.
Of the 323 referrals, 24% (37%) conformed to the Norwegian (British) « guide », 34% (46%) did not conform, and 42% (18%) were considered uncertain, mainly because of lack of pertinent information in the referral letters.
A total of 182 examinations were in disagreement with one or both « guides ».
Only 4 of these examinations revealed potentially important findings (osteoporotic fractures in 2 patients, uncertain sacroiliac joint arthritis in 1 patient, and « probably benign » sclerotic densities in 1 patient).
In the interview group, the proportion of non-conforming referrals was 40% (48%) based on the referral letters, and 31% (30%) when the interview data were taken into account.
A great proportion of referrals for plain radiography of the lumbosacral spine do not conform to recent clinical recommendations. (...)
Mots-clés Pascal : Lombalgie, Homme, Norvège, Europe, Exploration radiologique, Rachis lombosacré, Lombosacré, Indication, Médecin généraliste, Radiographie, Comportement individuel, Soin santé primaire, Douleur, Système ostéoarticulaire pathologie, Rachis pathologie, Rachialgie
Mots-clés Pascal anglais : Low back pain, Human, Norway, Europe, Radiologic investigation, Lumbosacral spine, Lumbosacral, Indication, General practitioner, Radiography, Individual behavior, Primary health care, Pain, Diseases of the osteoarticular system, Spine disease, Rachialgia
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0105650
Code Inist : 002B30A01B. Création : 16/11/1999.