Evaluation of imaging ordering by general practitioners in Australia, 2002-03 to 2011-12

Book excerpt: This book reports changes in GP ordering of imaging tests in Australia from 2002-03 to 2011-12, 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% 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.