Variation in test ordering behaviour of GPs: professional or context-related factors?

Objective: The aim of this study was to describe GPs' test ordering behaviour, and to establish professional and context-related determinants of GPs' inclination to order tests.

Methods: A cross-sectional analysis was carried out of 229 GPs in 40 local GP groups from five regions in The Netherlands of the combined number of 19 laboratory and eight imaging tests ordered by GPs, collected from five regional diagnostic centres. In a multivariable multilevel regression analysis, these data were linked with survey data on professional characteristics such as knowledge about and attitude towards test ordering, and with data on context-related factors such as practice type or experience with feedback on test ordering data.

A multidisciplinary guideline for the acute phase of stroke: barriers perceived by Dutch neurologists.

Rationale, Aims And Objectives: Guidelines for stroke management should improve quality of care. Dissemination of guidelines, however, does not guarantee guideline adherence. The aim of this paper is to investigate barriers for guideline adherence to bring about suggestions for possible implementation strategies.

Barriers to implementing cardiovascular risk tables in routine general practice.

Design: Qualitative study. GPs were interviewed after analysing two audiotaped cardiovascular consultations.

Setting: Primary health care.

Unexplained complaints in general practice: prevalence, patients' expectations, and professionals' test-ordering behavior.

Objective: To gain insight into general practitioners' (GPs) test-ordering behavior for patients presenting with unexplained complaints. An unexplained complaint's symptoms are not alarming, and there is no plausible medical or psychosocial explanation for it. The Dutch College of General Practitioners (DCGP) recommends a watchful, waiting attitude for test ordering for unexplained complaints.

Effect of a practice-based strategy on test ordering performance of primary care physicians: a randomized trial.

Context: Numbers of diagnostic tests ordered by primary care physicians are growing and many of these tests seem to be unnecessary according to established, evidence-based guidelines. An innovative strategy that focused on clinical problems and associated tests was developed.

Objective: To determine the effects of a multifaceted strategy aimed at improving the performance of primary care physicians' test ordering.

Understanding laboratory testing in diagnostic uncertainty: a qualitative study in general practice.

Background: Better knowledge of the professional's motives for ordering laboratory tests in the case of diagnostic uncertainty may lead to interventions directed at reducing unnecessary testing.

Aim: To gain insight into the general practitioner's (GP's) motives for ordering laboratory tests for patients presenting with unexplained complaints.

Design Of Study: Semi-structured interviews based on surgery observations.