Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2008
Cost-effectiveness of magnetic resonance imaging of the knee for patients presenting in primary care.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 21 papers, 3 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
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Patient beliefs and perceptions play a crucial role in the decision-making process when managing a meniscal tear. A qualitative systematic review of the literature.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Pooled it
- Musculoskeletal care pathways for adults with hip and knee pain referred for specialist opinion: a systematic review.BMJ open · 2019Pooled 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
- Predicting no return to sports after three months in patients with traumatic knee complaints in general practice by combining patient characteristics, trauma characteristics and knee complaints.The European journal of general practice · 2019Trial
- The effect of waiting times from general practitioner referral to MRI or orthopaedic consultation for the knee on patient-based outcomes.The British journal of radiology · 2012Trial
- Participants' preference for type of leaflet used to feed back the results of a randomised trial: a survey.Trials · 2010Trial
- Effectiveness of GP access to magnetic resonance imaging of the knee: a randomised trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2008Trial
- Irish general practitioner (GP) perspectives on impact of direct access radiology on patient care in the community: results from a mixed-methods study.Irish journal of medical science · 2024Article
- Magnetic Resonance Imaging in the Year Prior to Total Knee Arthroplasty: A Potential Overutilization of Healthcare Resources.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023Article
- Is MRI Overutilized for Evaluation of Knee Pain in Veterans?The journal of knee surgery · 2023Article
- Unintended consequences: quantifying the benefits, iatrogenic harms and downstream cascade costs of musculoskeletal MRI in UK primary care.BMJ open quality · 2021Article
- Unicompartmental knee arthroplasty, an enigma, and the ten enigmas of medial UKA.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2020Review
- A categorisation of problems and solutions to improve patient referrals from primary to specialty care.BMC health services research · 2018Review
- Exploring interprofessional collaboration during the integration of diabetes teams into primary care.BMC family practice · 2016Article
- A clinical prediction rule for meniscal tears in primary care: development and internal validation using a multicentre study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
- Six principles to enhance health workforce flexibility.Human resources for health · 2015Article
- Advanced imaging: use and misuse.Journal of feline medicine and surgery · 2012Review
- Radiology and primary care in Europe.Insights into imaging · 2010Article
- Only MR can safely exclude patients from arthroscopy.Skeletal radiology · 2009Article
- Direct access to diagnostic services.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009Article
Corrections and comments
- Erratum issuedCorrections.2018
Authors and funding
1 author.
Funding
Abstract
backgroundMusculoskeletal problems generate high costs. Of these disorders, patients with knee problems are commonly seen by GPs. Magnetic resonance imaging (MRI) of the knee is an accurate diagnostic test, but there is uncertainty as to whether GP access to MRI for these patients is a cost-effective policy.
aimTo investigate the cost-effectiveness of GP referral to early MRI and a provisional orthopaedic appointment, compared with referral to an orthopaedic specialist without prior MRI for patients with continuing knee problems. DESIGN OF STUDY: Cost-effectiveness analysis alongside a pragmatic randomised trial.
settingFive-hundred and thirty-three patients consulting their GP about a knee problem were recruited from 163 general practices at 11 sites across the UK.
methodTwo-year costs were estimated from the NHS perspective. Health outcomes were expressed in terms of quality-adjusted life years (QALYs), based on patient responses to the EQ-5D questionnaire administered at baseline, and at 6, 12, and 24 months' follow-up.
resultsEarly MRI is associated with a higher NHS cost, by £294 ($581; €435) per patient (95% confidence interval [CI] = £31 to £573), and a larger number of QALYs, by 0.050 (95% CI = −0.025 to 0.118). Mean differences in cost and QALYs generated an incremental cost per QALY gained of £5840 ($11 538; €8642). At a cost per QALY threshold of £20 000, there is a 0.81 probability that early MRI is a cost-effective use of NHS resources [corrected].
conclusionGP access to MRI for patients presenting in primary care with a continuing knee problem represents a cost-effective use of health service resources.
Indexed as
Identifiers
What 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.