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 measure
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 (if study stopped)
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
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
Basic results (scientific)
Publication list
2002 results in: http://www.ncbi.nlm.nih.gov/pubmed/12014939
Publication citations
-
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.