Adequacy and quality of abdominal echographies requested by primary care professionals.
BACKGROUND
The value of abdominal echography in primary care is great because it is innocuous, inexpensive, easy to perform and provides a great deal of information making this the first examination to be requested in cases of probable abdominal disease. However, too many abdominal echographies are probably requested overcrowding the Departments of Radiodiagnosis with not always justified petitions or with repetition of tests based on little clinical criteria.


METHODS
The aim of the study is to evaluate the adequacy and quality of abdominal echographies requested by primary care physicians in the Maresme County (North of Barcelona), develop guidelines for indicating echographies and reevaluate this adequacy after implementing these guidelines.We will perform a two-phase study: the first descriptive, and retrospective evaluating the adequacy and quality of petitions for abdominal echographies, and in the second phase we will evaluate the impact of recommendations for indicating abdominal echographies for PC physicians on the adequacy and quality of echography petitions thereafter.This study will be carried out in 10 primary care centres in the Maresme (Barcelona).1067 abdominal echographies requested by primary care physicians from the above mentioned centres from January 2007 to April 2010 and referred to the Department of Radiology and the same number of applications after the intervention.All the petitions for abdominal echographies requested will be analysed and the clinical histories will be obtained to determine demographic variables, the reason for the visit and for the echography petition and diagnostic orientation, clinical and echographic data, evaluation of the echographies according to the quality and variables characterising the professionals requesting the echographies including: age, sex, laboral situation, length of time in work post, formation, etc.To achieve a consensus of the adequacy of abdominal echography, a work group including gastroenterologists, radiologists and general practitioners will be created following the nominal group. This will allow the design of guidelines for the indication of abdominal echography and posterior evaluation of their impact among physicians by diffusion and posterior reevaluation of the adequacy of the petitions.
Auladell
Ma Antònia
MA
Primary Healthcare Centre Premià de Mar, Catalan Health Institute, IDIAP Jordi Gol, La Plaça 93, 08330 Premià de Mar, Spain.
Caballeria
Llorenç
L
Pera
Guillem
G
Rodríguez
Lluís
L
Casas
José Dario
JD
Aznar
Jesús
J
Miranda
Dolores
D
Sánchez
Carmen
C
Negrete
Antonio
A
Castellví
Josep Ma
JM
Bernad
Jesús
J
Canut
Santiago
S
Aubà
Josep
J
Aizpurua
Miren Maite
MM
Torán
Pere
P
D000005:Abdomen / Q000000981:diagnostic imaging*; D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D032921:Consensus; D006801:Humans; D058007:Physicians, Primary Care; D011320:Primary Health Care / Q000592:standards; D012017:Referral and Consultation / Q000592:standards*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014463:Ultrasonography
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