ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2011
Open-access transvaginal sonography in women of reproductive age with abnormal vaginal bleeding: a descriptive study in general practice.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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- 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
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4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnostic ultrasonography is used by GPs in approximately 10% of patients of reproductive age with abnormal vaginal bleeding. Transvaginal sonography is recommended as a first-line diagnostic instrument for assessing uterine pathology.
aimTo assess if findings resulting from open-access sonography were in agreement with the GPs' working hypotheses and if these findings contributed to GPs' management. DESIGN AND
settingProspective observational cohort study of GPs working in the health district of the Academic Medical Center, Amsterdam and their patients consulting with abnormal vaginal bleeding.
methodData on patients' history, GPs' primary working hypotheses, and intended management were recorded. After sonography, GPs recorded their actual management.
resultsA total of 122 patients were included by 18 GPs from June 2003 to December 2004. Data from 89 patients were available for analysis. The GPs' working hypotheses implied 'no structural pathology' in 65/89 patients, and 'fibroids' in 24/89 patients. Sonographic findings were confirmed in 50/65 patients where 'no structural pathology', and in 14/24 of those where 'fibroids' were expected. Initially, GPs had intended to refer nine patients to a gynaecologist. Actual management after sonographic assessment was watchful waiting or drug therapy in 57/89 patients. Eighty-nine per cent of these patients had normal sonographic findings. The actual referral rate rose to 27/89 patients. In 17 referred patients, sonographic findings were suggestive of intracavitary abnormalities.
conclusionOpen-access sonography contributed to more accurate diagnoses and improved GPs' management of women with abnormal vaginal bleeding.
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