[Radiography of the lumbosacral spine--do the referrals conform to clinical recommendations?].
The aim of this study was to evaluate how referrals from Norwegian general practitioners for plain radiography of the lumbosacral spine conform to clinical recommendations. The clinical information given in 274 referral letters was compared with Norwegian and British recommendations. We also interviewed 99 of the patients about symptoms and prior radiographs, and performed a new comparison using all available information. Only 27% (43%) of the 274 referrals conformed to the Norwegian (British) recommendations, 36% (41%) did not conform, and 37% (16%) were considered uncertain, mainly because of lack of pertinent information in the referral letters. Of 143 referrals which were in disagreement with the Norwegian and/or the British recommendations, only four resulted in "important" findings (osteoporotic fractures in two patients, uncertain sacroiliac joint arthritis in one patient, and probably benign bony sclerosis in one patient). In the interview group, the proportion of non-conforming referrals decreased from 40% (47%) to 31% (29%) when the additional clinical information was considered. Nevertheless, we conclude that a substantial proportion of referrals for plain radiography of the lumbosacral spine do not conform to clinical recommendations. Referrals outside the advised criteria yield few relevant findings and could probably be cancelled.
Radiologisk seksjon, Universitetet i Bergen.
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Espeland
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Albrektsen
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JL
Larsen
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009664:Norway; D011859:Radiography; D012017:Referral and Consultation; D013122:Spinal Diseases / Q000000981:diagnostic imaging*; D011795:Surveys and Questionnaires; D006113:United Kingdom
Røntgen lumbosakralcolumna--er henvisningene i samsvar med kliniske anbefalinger?