Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2003
A randomised controlled trial of joint consultations with general practitioners and cardiologists in primary care.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Referral interventions from primary to specialist care: a systematic review of international evidence.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Pooled it
- Service organisation for the secondary prevention of ischaemic heart disease in primary care.The Cochrane database of systematic reviews · 2010Pooled it
- Trial
- Virtual outreach: economic evaluation of joint teleconsultations for patients referred by their general practitioner for a specialist opinion.BMJ (Clinical research ed.) · 2003Trial
- Article
- Telemedicine as a tool for continuing medical education.Family practice · 2023Article
- Article
- Can care coordination across levels be improved through the implementation of participatory action research interventions? Outcomes and conditions for sustaining changes in five Latin American countries.BMC health services research · 2020Article
- Substitution of hospital care with Primary Care Plus: differences in referral patterns according to specialty, specialist and diagnosis group.BMC family practice · 2019Article
- Substituting hospital-based outpatient cardiology care: The impact on quality, health and costs.PloS one · 2019Article
- Shifting hospital care to primary care: An evaluation of cardiology care in a primary care setting in the Netherlands.BMC family practice · 2018Observational
- Does an in-house internist at a GP practice result in reduced referrals to hospital-based specialist care?Scandinavian journal of primary health care · 2018Article
- Doctors' opinion on the contribution of coordination mechanisms to improving clinical coordination between primary and outpatient secondary care in the Catalan national health system.BMC health services research · 2017Article
- Substitution of outpatient care with primary care: a feasibility study on the experiences among general practitioners, medical specialists and patients.BMC family practice · 2016Article
- Substitution of Hospital Care with Primary Care: Defining the Conditions of Primary Care Plus.International journal of integrated care · 2016Article
- Organisation of services for people with cardiovascular disorders in primary care: transfer to primary care or to specialist-generalist multidisciplinary teams?BMC family practice · 2014Article
- Exploring public perspectives on e-health: findings from two citizen juries.Health expectations : an international journal of public participation in health care and health policy · 2011Article
- [Organisational reforms in the relationships between general doctors and specialists: impact on referrals].Atencion primaria · 2010Article
- Teleconsultation service to improve healthcare in rural areas: acceptance, organizational impact and appropriateness.BMC health services research · 2009Article
- Motives and preferences of general practitioners for new collaboration models with medical specialists: a qualitative study.BMC health services research · 2007Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundJoint consultation sessions of a small group of general practitioners (GPs) and a specialist in orthopaedics proved to be an effective way of decreasing the referral rate of orthopaedic patients. Cardiac complaints comprise an important category of health problems with high referral rates.
aimsTo study the effects of joint consultation on the quality of care and referrals for patients with cardiac complaints. DESIGN OF STUDY: Randomised controlled trial.
settingForty-nine GPs participated in 16 consultation groups, each with one of 13 cardiologists, in monthly joint consultations over a period of about 18 months.
methodThe GPs selected patients about whom they were uncertain, and those needing urgent referral were excluded. Patients were randomly assigned to joint consultation or to usual care. After a follow-up period all patients had a joint consultation for outcome assessment. Referral data were provided by two regional health insurance companies and questionnaires were given to the patients, GPs, and cardiologists to gauge their opinion of the trial.
resultsOne hundred and forty-eight patients in the intervention group and 158 patients in the control group fulfilled the whole protocol. The quality of care was similar in both groups. In the intervention group, 34% of the patients were referred, compared with 55% in the control group (P = 0.001), and fewer patients underwent further diagnostic procedures (7% compared with 16%, P = 0.013). Referrals to cardiology as a proportion of all referrals decreased in the practices of the participating GPs, compared with their reference districts (P = 0.024).
conclusionJoint consultation is an effective method that provides a quality of care that at least equals usual care and that contributes to a better selection of patients who need specialist care.
Indexed as
Identifiers
12817355PMC1314509What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.