AN AUDIT OF GENERAL-PRACTITIONER REQUESTS FOR PELVIC ULTRASOUND - ANALYSIS OF REFERRAL PATTERNS AND OUTCOME

Objectives 1. To assess the information supplied by general practition ers on the gynaecological ultrasound request form and to determine how this information influences the interpretation of scans; and 2. To ex amine the influence of scans on the subsequent management of patients both by general practitioners and, where relevant, by hospital gynaeco logists. Design Retrospective analysis of gynaecological ultrasound re quests made by general practitioners. Postal questionnaire and assessm ent of outcome according to general practitioners' records and, where appropriate, the hospital notes. Setting A London teaching hospital gy naecological ultrasound department and associated general practices. S ubjects Four hundred ninety-eight women referred by general practition ers for a gynaecological ultrasound scan over a one year period (1990) . Results The 498 requests for gynaecological ultrasound scans include d 472 primary diagnostic referrals. Seventy-one percent of general pra ctitioners replied to the questionnaires. Overall, 46% of the scans we re normal, but the proportion of normal scans fell to 21% if the date of the last menstrual period and a pregnancy test result were included on the form. Forty per cent of women scanned subsequently were referr ed for hospital care. Conclusions General practitioners would appear t o use the ultrasound service in a rational way and therefore there can be no justification for not allowing them open access. The positive d iagnostic yield can be further improved if time is taken to supply sim ple relevant information which may be facilitated by a specific reques t form.