Condition category
Not Applicable
Date applied
23/01/2004
Date assigned
23/01/2004
Last edited
12/12/2013
Prospective/Retrospective
Retrospectively registered
Overall trial status
Completed
Recruitment status
No longer recruiting

Plain English Summary

Not provided at time of registration

Trial website

Contact information

Type

Scientific

Primary contact

Dr Helen Houston

ORCID ID

Contact details

Department of General Practice
Llanedeyrn Health Centre
Cardiff
CF23 9PN
United Kingdom
+44 (0)129 20 541 133
Houston@cardiff.ac.uk

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

PSI03-44

Study information

Scientific title

Acronym

Study hypothesis

1. 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

Not provided at time of registration

Study design

Randomised controlled trial

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

GP practices

Trial type

Screening

Patient information sheet

Condition

GPs' use of MRI scans

Intervention

Face 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 type

Other

Phase

Not Specified

Drug names

Primary outcome measures

1. 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 measures

No secondary outcome measures

Overall trial start date

01/04/1995

Overall trial end date

01/06/1998

Reason abandoned

Eligibility

Participant inclusion criteria

150 general practitioners in 39 practices

Participant type

Patient

Age group

Not Specified

Gender

Not Specified

Target number of participants

150

Participant exclusion criteria

No exclusion criteria

Recruitment start date

01/04/1995

Recruitment end date

01/06/1998

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Department of General Practice
Cardiff
CF23 9PN
United Kingdom

Sponsor information

Organisation

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

Sponsor details

The Department of Health
Richmond House
79 Whitehall
London
SW1A 2NL
United Kingdom
+44 (0)20 7307 2622
dhmail@doh.gsi.org.uk

Sponsor type

Government

Website

http://www.doh.gov.uk

Funders

Funder type

Government

Funder name

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

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Results - basic reporting

Publication summary

2002 results in: http://www.ncbi.nlm.nih.gov/pubmed/12014939

Publication citations

  1. Results

    Robling MR, Houston HL, Kinnersley P, Hourihan MD, Cohen DR, Hale J, Hood K, 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., Clin Radiol, 2002, 57, 5, 402-407, doi: 10.1053/crad.2001.0864.

Additional files

Editorial Notes