SynthesisQuality & safety in health care2010
Can guidelines improve referral to elective surgical specialties for adults? A systematic review.
Synthesis in Quality & safety in health care, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 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
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The effectiveness of different patient referral systems to shorten waiting times for elective surgeries: systematic review.BMC health services research · 2021Pooled it
- The Situation of Safe Surgery and Anaesthesia in Tanzania: A Systematic Review.World journal of surgery · 2019Pooled it
- Evaluation of the 2020 American Urological Association Microscopic Hematuria Guidelines in Clinical Practice: Retrospective Chart Review Analysis.JMIR formative research · 2025Article
- Article
- Understanding Primary Care Providers' Attitudes and Practices for Hearing Loss Screening, Diagnosis, and Treatment.Journal of the American Academy of Audiology · 2025Article
- Hospitalizations for Ambulatory Care Sensitive Conditions in a Large City of Japan: a Descriptive Analysis Using Claims Data.Journal of general internal medicine · 2022Observational
- Factors affecting the successful implementation of the referral system: A scoping review.Journal of family medicine and primary care · 2021Article
- A cohort study of a general surgery electronic consultation system: safety implications and impact on surgical yield.BMC health services research · 2017Article
- Behavior change interventions and policies influencing primary healthcare professionals' practice-an overview of reviews.Implementation science : IS · 2017Review
- Improving the effectiveness and efficiency of outpatient services: a scoping review of interventions at the primary-secondary care interface.Journal of health services research & policy · 2017Article
- Promoting professional behaviour change in healthcare: what interventions work, and why? A theory-led overview of systematic reviews.BMJ open · 2015Review
- Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon - general practitioner Delphi approach.Journal of multidisciplinary healthcare · 2014Article
- Improving Compliance with NICE Guidelines on Parkinson's isease: A Quality Improvement Study.Annals of medicine and surgery (2012) · 2012Article
- Elective surgical referral guidelines--background educational material or essential shared decision making tool? A survey of GPs' in England.BMC family practice · 2011Article
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
aimTo assess effectiveness of guidelines for referral for elective surgical assessment.
methodSystematic review with descriptive synthesis. DATA SOURCES: Medline, EMBASE, CINAHL and Cochrane database up to 2008. Hand searches of journals and websites. SELECTION OF STUDIES: Studies evaluated guidelines for referral from primary to secondary care, for elective surgical assessment for adults. OUTCOME MEASURES: Appropriateness of referral (usually measured as guideline compliance) including clinical appropriateness, appropriateness of destination and of pre-referral management (eg, diagnostic investigations), general practitioner knowledge of referral appropriateness, referral rates, health outcomes and costs.
results24 eligible studies (5 randomised control trials, 6 cohort, 13 case series) included guidelines from UK, Europe, Canada and the USA for referral for musculoskeletal, urological, ENT, gynaecology, general surgical and ophthalmological conditions. Interventions varied from complex ("one-stop shops") to simple guidelines. Four randomized control trials reported increases in appropriateness of pre-referral care (diagnostic investigations and treatment). No evidence was found for effects on practitioner knowledge. Mixed evidence was reported on rates of referral and costs (rates and costs increased, decreased or stayed the same). Two studies reported on health outcomes finding no change.
conclusionsGuidelines for elective surgical referral can improve appropriateness of care by improving pre-referral investigation and treatment, but there is no strong evidence in favour of other beneficial effects.
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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.