REFERRALS FOR RADIOLOGICAL EXAMINATION OF THE LARGE-BOWEL - PRE-RADIOLOGICAL EXAMINATIONS, TESTS AND REFERRAL LETTERS

The aims of the present study were to assess the frequency of examinat ions or tests before referral for a barium enema, to identify predicto rs for the use of such examinations or tests and to evaluate the quali ty of the referral letters. 1852 patients completed a questionnaire on symptoms and examinations or tests performed before referral. Symptom s, examination procedures, laboratory data and reason for referral wer e registered in 1781 referral letters and were compared with the infor mation given by the patients. Serum haemoglobin was measured in 76%, p er-rectal examination in 45%, faecal occult blood tests in 37% and pro ctosigmoidoscopy in only 16% of the patients. High age was a significa nt predictor for all examinations, and patients with rectal bleeding a nd rectal pain were more often examined rectally, although this was om itted in several patients with such symptoms. All evaluated informatio n was reported significantly more frequently by the patients than by t he doctors in the referral letters. The very low figures for rectal ex aminations and the lack of completeness and adequacy of the informatio n in the referral letters underline the need for efforts to change doc tors' behaviour when investigating and referring patients with possibl e colorectal disease.