[Summary of the 'Stroke' guideline of the Dutch College of General Practitioners' (NHG)].

The Dutch College of General Practitioners (NHG) guideline 'Stroke' covers the diagnosis, management and long-term care of stroke in general practice. Patients with neurological symptoms suspected to be due to cerebral infarction or haemorrhage should be transferred directly to a stroke unit. The specialized care provided by these units, including emergency interventions (e.

Improving test ordering in primary care: the added value of a small-group quality improvement strategy compared with classic feedback only.

Purpose: We wanted to evaluate the added value of small peer-group quality improvement meetings compared with simple feedback as a strategy to improve test-ordering behavior. Numbers of tests ordered by primary care physicians are increasing, and many of these tests seem to be unnecessary according to established, evidence-based guidelines.

Methods: We enrolled 194 primary care physicians from 27 local primary care practice groups in 5 health care regions (5 diagnostic centers).

Block design allowed for control of the Hawthorne effect in a randomized controlled trial of test ordering.

Background And Objective: To evaluate the value of balanced incomplete block designs in quality improvement research, and their capacity to control for the Hawthorne effect.

Methods: General practitioners teams were randomized into three arms and received an intervention on test ordering, relating to tests for two groups of clinical problems (A tests and B tests). In the two trials within the block design, we tried to control for the Hawthorne effect by comparing the complete intervention in both arms on either the A (arm I) or B tests (arm II); the arms acted as blind controls for each other.

Comparing cost effects of two quality strategies to improve test ordering in primary care: a randomized trial.

Objective: To determine the costs and cost reductions of an innovative strategy aimed at improving test ordering routines of primary care physicians, compared with a traditional strategy.

Design: Multicenter randomized controlled trial with randomization at the local primary care physicians group level.

Setting: Primary care: local primary care physicians groups in five regions of the Netherlands with diagnostic centers.

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.

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.