RANDOMIZED CONTROLLED TRIAL OF THE EFFECT OF THE ROYAL-COLLEGE-OF-RADIOLOGISTS GUIDELINES ON GENERAL-PRACTITIONERS REFERRALS FOR RADIOGRAPHIC EXAMINATION

Background. The Royal College of Radiologists' guidelines aim to encou rage more appropriate use of diagnostic radiology and so reduce the us e of clinically unhelpful x-ray examinations. Aim. The object of this study was to conduct a randomized controlled trial of the introduction of the guidelines into general practice. Method. A total of 62 practi ces (170 general practitioners) referring patients to St George's Hosp ital, London for diagnostic radiology were randomly allocated into two groups. Guidelines were sent to the 30 practices in the intervention group. Radiological referral patterns were compared in both groups bef ore and after the introduction of guidelines. Results. Practices which had received guidelines requested significantly fewer examinations of the spine, and made a significantly higher proportion of requests whi ch conformed to the guidelines compared with practices which had not r eceived the guidelines. There were no significant differences in the p roportion of forms giving physical findings or in the proportion of po sitive findings at radiology. Conclusion. introduction of guidelines c an influence general practitioners' radiological referrals in the shor t term. Wider use of guidelines might help to reduce unnecessary irrad iation of patients.