title: First quality score for referral letters in gastroenterology-a validation study.
abstract: To create and validate an objective and reliable score to assess referral quality in gastroenterology.
  
  
  
  An observational multicentre study.
  
  
  
  25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist.
  
  
  
  Correlation between the TPS and a visual analogue scale (VAS) for referral quality.
  
  
  
  The 327 referrals had an average TPS of 13.2 (range 1-25) and an average VAS of 4.7 (range 0.2-9.5). The reliability of the score was excellent, with an intra-rater intraclass correlation coefficient (ICC) of 0.87 and inter-rater ICC of 0.91. The overall correlation between the TPS and the VAS was moderate (r=0.42), and ranged from fair to substantial for the various indications. Mean agreement was good (ICC=0.47, 95% CI (0.34 to 0.57)), ranging from poor to good.
  
  
  
  The TPS is reliable, objective and shows good agreement with the subjective VAS. The score may be a useful tool for assessing referral quality in gastroenterology, particularly important when evaluating the effect of interventions to improve referral quality.
authors.affiliation: Department of Medical Research, Vestre Viken Hospital Trust Bærum, Drammen, Norway.
authors.forename: Sigrun Losada
authors.initials: SL
authors.lastname: Eskeland
authors.affiliation: Research Support Services, Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Cathrine
authors.initials: C
authors.lastname: Brunborg
authors.affiliation: Department of Medicine, Vestfold Hospital Trust Tønsberg, Tønsberg, Norway.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Seip
authors.affiliation: Department of Medicine, Vestre Viken Hospital Trust Bærum, Drammen, Norway.
authors.forename: Kristine
authors.initials: K
authors.lastname: Wiencke
authors.affiliation: Department of Gastroenterology, Innlandet Hospital Trust Gjøvik, Gjøvik, Norway.|Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Øistein
authors.initials: Ø
authors.lastname: Hovde
authors.affiliation: Department of Gastroenterology, Østfold Hospital Kalnes, Kalnes, Norway.
authors.forename: Tanja
authors.initials: T
authors.lastname: Owen
authors.affiliation: Department of Medicine, Innlandet Hospital Trust Lillehammer, Lillehammer, Norway.
authors.forename: Erik
authors.initials: E
authors.lastname: Skogestad
authors.affiliation: Department of Gastroenterology, Telemark Hospital Trust Skien, Skien, Norway.
authors.forename: Gert
authors.initials: G
authors.lastname: Huppertz-Hauss
authors.affiliation: Department of Medicine, Vestre Viken Hospital Trust Drammen, Drammen, Norway.
authors.forename: Fred-Arne
authors.initials: FA
authors.lastname: Halvorsen
authors.affiliation: Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.|Department of Health Economics and Health Management, University of Oslo, Oslo, Norway.
authors.forename: Kjetil
authors.initials: K
authors.lastname: Garborg
authors.affiliation: Department of Gastroenterology, Oslo University Hospital, Oslo, Norway.
authors.forename: Lars
authors.initials: L
authors.lastname: Aabakken
authors.affiliation: Department of Medicine, Vestre Viken Hospital Trust Bærum, Drammen, Norway.|Cancer Registry of Norway, Oslo University Hospital, Oslo, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: de Lange
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist; D002648:Child; D005260:Female; D005762:Gastroenterology; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D015431:Weight Loss; D055815:Young Adult
keywords: PRIMARY CARE