ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2010
Impact of GP direct-access computerised tomography for the investigation of chronic daily headache.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Interventions to reduce the time to diagnosis of brain tumours.The Cochrane database of systematic reviews · 2020Pooled it
- Direct access cancer testing in primary care: a systematic review of use and clinical outcomes.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Symptomatic diagnosis of cancer of the brain and central nervous system in primary care: a systematic review.Family practice · 2015Pooled 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
- Development of high-throughput ATR-FTIR technology for rapid triage of brain cancer.Nature communications · 2019Trial
- Article
- Article
- Does clinical validation and the implementation of new models of outpatient service delivery have the potential to reduce waiting lists? A pilot study in Letterkenny University Hospital.Irish journal of medical science · 2020Article
- Direct access CT for suspicion of brain tumour: an analysis of referral pathways in a population-based patient group.BMC family practice · 2019Article
- Should GPs have direct access to imaging for headache? A qualitative study of patients' views in the UK.BMJ open · 2019Article
- Missed opportunities for diagnosing brain tumours in primary care: a qualitative study of patient experiences.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Article
- A categorisation of problems and solutions to improve patient referrals from primary to specialty care.BMC health services research · 2018Review
- Symptoms in primary care with time to diagnosis of brain tumours.Family practice · 2018Article
- Health economic evaluation of a serum-based blood test for brain tumour diagnosis: exploration of two clinical scenarios.BMJ open · 2018Article
- Primary care management of headaches and how direct-access MRI fits: a qualitative study of UK general practitioners' views.BMJ open · 2017Article
- Achieving a balance between the physical and the psychological in headache.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- 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
- The use of neuroimaging in dementia by Irish general practitioners.Irish journal of medical science · 2016Article
- Prevalence of normal head CT and positive CT findings in a large cohort of patients with chronic headaches.The neuroradiology journal · 2015Article
- CT and chronic daily headache.The British journal of general practice : the journal of the Royal College of General Practitioners · 2011Article
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5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronic daily headache is a major healthcare problem, with significant resource implications for specialist services. Since 1999, GPs in Greater Glasgow have had direct access to computerised tomography (CT) for investigation of chronic daily headache.
aimThe purpose of this study is to assess the significance of pathology, impact of the service, and GP satisfaction.
methodThe direct-access CT findings in patients between 1999 and 2007 were reviewed. Radiological reports were reviewed for abnormal findings by a radiologist. A neurologist reviewed those cases with abnormalities to assess their potential causation in presenting symptoms. A questionnaire was sent to the referring GP for every patient referred for direct-access CT. Data from the Information Services Division of NHS National Services Scotland was used to estimate potential cost benefits.
resultsA total of 4404 CT scans were performed. Abnormal findings were reported in 461 (10.5%), and the reported abnormalities were considered a potential causative factor for the presenting symptoms in 60 patients (1.4%). Other abnormalities mostly resulted from established cerebrovascular disease and atrophy; 986 GP questionnaires were analysed. The major body of GP opinion (n = 460, 47%) indicated that direct-access CT was their preferred choice for referral of chronic daily headache. If direct-access CT was not available, neurology (n = 448, 45%) and general medicine (n = 379, 38%) would be the commonest referral choices. This study also reveals that 86% did not require further specialist referral. Projecting the GP questionnaire data to the study group gave an approximate cost saving of at least £86 681.81.
conclusionDirect-access CT is now the preferred choice of management for patients with chronic daily headache in primary care. Patients and GPs are reassured by a normal scan in the majority of cases. There may be cost savings, although confirmation of cost-effectiveness would require further study.
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