An evaluation of general practitioners' use of magnetic resonance imaging (MRI)

ISRCTN ISRCTN17934656
DOI https://doi.org/10.1186/ISRCTN17934656
Secondary identifying numbers PSI03-44
Submission date
23/01/2004
Registration date
23/01/2004
Last edited
12/12/2013
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Other
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Helen Houston
Scientific

Department of General Practice
Llanedeyrn Health Centre
Cardiff
CF23 9PN
United Kingdom

Phone +44 (0)129 20 541 133
Email Houston@cardiff.ac.uk

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)GP practice
Study typeScreening
Scientific title
Study objectives1. To determine base line data on current use of Magnetic Resonance Imaging (MRI) by general practitioners and its effect on referrals and patient management
2. To develop consensus-based referral guidelines for GPs for the two anatomical sites most frequently requested by GPs
3. To compare two methods of accessing MRI with rates of appropriate scan requests as the main outcome measure
4. To develop education and audit materials with which to disseminate the referral guidelines
5. To evaluate the impact of the two interventions on GP knowledge and appropriateness of scan request
6. To assess the cost effectiveness of the different implementation strategies
Ethics approval(s)Not provided at time of registration
Health condition(s) or problem(s) studiedGPs' use of MRI scans
InterventionFace to face qualitative interviews were conducted with a sample of general practitioners. Data from the interviews were used by a panel of doctors from primary and secondary care to develop guidelines for the appropriate referral of patients for MRI of the knee and of the lumbar spine.

General practices were randomised to access MRI by telephone or letter. Referrals were judged by the panel (blind) for appropriateness with the guidelines as criteria. A difference in the proportion of appropriate scan requests before telephone and written access groups was assessed using the chi-square test. Costs of method of access were determined.

GP knowledge was assessed immediately before and three months after the intervention by postal questionnaire. Telephone interviews with GPs for all subsequent scan requests provided data on which the panel (again blind) assessed against the guideline criteria. The association between practice, patient and randomisation variables with concordance was assessed using stepwise logistic regression. Clustering effects were accounted for by multi-level modelling. The cost of each intervention was measured.

Practices were randomised to receive:
a. Educational seminar
b. Audit feedback
c. Seminar and audit feedback
d. None

All four groups received guidelines.
Intervention typeOther
Primary outcome measure1. Consensus guidelines produced, feedback from GPs
2. Concordance of requests with guidelines
3. Knowledge of indications and contraindications for MRI
4. Cost of method of access
5. Cost of implementation strategy
Secondary outcome measuresNo secondary outcome measures
Overall study start date01/04/1995
Completion date01/06/1998

Eligibility

Participant type(s)Patient
Age groupNot Specified
SexNot Specified
Target number of participants150
Key inclusion criteria150 general practitioners in 39 practices
Key exclusion criteriaNo exclusion criteria
Date of first enrolment01/04/1995
Date of final enrolment01/06/1998

Locations

Countries of recruitment

  • United Kingdom
  • Wales

Study participating centre

Department of General Practice
Cardiff
CF23 9PN
United Kingdom

Sponsor information

Record Provided by the NHS R&D 'Time-Limited' National Programme Register - Department of Health (UK)
Government

The Department of Health
Richmond House
79 Whitehall
London
SW1A 2NL
United Kingdom

Phone +44 (0)20 7307 2622
Email dhmail@doh.gsi.org.uk
Website http://www.doh.gov.uk

Funders

Funder type

Government

NHS Primary and Secondary Care Interface National Research and Development Programme (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/05/2002 Yes No