Main description:

This book reports changes in GP ordering of imaging tests in Australia from 2002-3 to 2011-2, and evaluates alignment between guidelines and recent GP test ordering for selected problems. Over the decade, 9,802 GPs participated in BEACH, providing details of 980,200 GP-patient encounters. The likelihood of GPs ordering imaging in the management of a problem increased over time. In recent practice, at least one imaging test was ordered at 9 per cent of encounters, at a rate of 10 imaging tests per 100 encounters. Diagnostic radiology was the most commonly ordered type of imaging test, but the order rate decreased over time, with a shift toward orders for ultrasound, CT and MRI, which all significantly increased. Eight selected problems accounted for one-third of all imaging orders. Imaging ordering behaviour suggests broad compliance with published guidelines in the management of osteoarthritis, shoulder problems, bursitis/tendonitis/synovitis, abdominal pain and other musculoskeletal injuries. Current ordering patterns for knee problems and some sprains/strains have potential for improvement. The ordering pattern for new presentations of back problems was inconsistent with all established guidelines for management of back problems.

Contents:

Acknowledgments
List of tables
List of figures and boxes
Summary Section 1: background, method and overview of GPs' imaging ordering
1. Introduction
2. Methods
3. The BEACH database
4. Imaging test ordering by GPs Section 2: problem-based investigation
5. Back problems
6. Osteoarthritis problems
7. Shoulder problems
8. Sprains and strains
9. Bursitis/tendonitis/synovitis
10. Abdominal pain problems
11. Knee problems
12. Other musculoskeletal injuries Section 3: test-based investigation
13. Problems for which diagnostic radiology, ultrasound, CT scan and MRI were ordered References
Abbreviations
Symbols
Glossary
Appendix 1: example of a 2011-12 recording form
Appendix 2: GP characteristics questionnaire, 2011-12
Appendix 3: patient information card, 2011-12
Appendix 4: initial results of analyses of the BEACH data by year, from 2002-03 to 2011-12 inclusive
Appendix 5: code groups from ICPC-2 and ICPC-2 PLUS