RANDOMIZED CONTROLLED TRIAL OF ROUTINE INDIVIDUAL FEEDBACK TO IMPROVERATIONALITY AND REDUCE NUMBERS OF TEST REQUESTS

Feedback can be described as a way to provide information on doctors' performance to enable changes in future behaviour. Feedback is used wi th the aim of changing test-ordering behaviour. It can lead to reducti ons in test usage and cost savings. It is not sufficiently clear, howe ver, whether feedback leads to more appropriate test use. Since 1985, the Diagnostic Coordinating Center Maastricht has been giving feedback on diagnostic tests as a routine health care activity to all family d octors in its region. Both quantity and quality of requests are discus sed. In a randomised, controlled trial over 2.5 years, discussion of t ests not included previously was added to the existing routine feedbac k. One group of family doctors (n=39) received feedback on test-group A (electrocardiography, endoscopy, cervical smears, and allergy tests) , the other (n=40) on test-group B (radiographic and ultrasonographic tests). Thus, each group of doctors acted as a control group for the o ther. Changes in volume and rationality of requests were analysed. The number of requests decreased during the trial (p=0.036). Request numb ers decreased particularly for test-group A (p=0.04); The proportion o f requests that were non-rational decreased more in the intervention t han in the control groups (p=0.009). Rationality improved predominantl y for test-group B (p=0.043). Thus, routine feedback can change the qu antity and quality of requests.