Evidence map›Paper›PMID 29637264›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2018

Requesting spinal MRIs effectively from primary care referrals.

Ignatius Liew, Fraser Dean, Gillian Anderson, Odhrán Murray

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ignatius LiewDepartment of Spine, Trauma and Orthopaedics, Queen Elizabeth University Hospital, 1345 Govan Road, Govan, Glasgow, G51 4TF, UK.ORCID 0000-0001-8020-7279
Fraser DeanDepartment of Spine, Trauma and Orthopaedics, Queen Elizabeth University Hospital, 1345 Govan Road, Govan, Glasgow, G51 4TF, UK.
Gillian AndersonDepartment of Management Science, University of Strathclyde Business School, Glasgow, UK.
Odhrán MurrayDepartment of Spine, Trauma and Orthopaedics, Queen Elizabeth University Hospital, 1345 Govan Road, Govan, Glasgow, G51 4TF, UK. odhran.murray@ggc.scot.nhs.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo define if MRI scans can accurately be requested based on information provided in the primary care referral and, therefore, streamline the patient journey. The demand for outpatient spinal appointments significantly exceeds our services' ability to provide efficient, high-quality patient care. Currently, magnetic resonance imaging (MRI) of the spine is requested following first consultation.

methodsDuring routine vetting of primary care referral letters, three consultant spinal surgeons recorded how likely they thought each patient would be to have an MRI scan. Following the first consultation with the spinal service, the notes of each patient were reviewed to see if an MRI was requested. We measured the positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity of ordering MRI scans based on primary care referral letters.

results149 patients were included [101 females, 48 males, mean age 49 (16-87)]. There were 125 routine, 21 urgent, and 3 'urgent-suspected cancer' referrals. The PPV of ordering MRIs before first consultation was 84%, NPV was 56% with the sensitivity and specificity being 82 and 59%, respectively. Ordering MRIs during initial vetting could shorten the patient journey with potential socioeconomic benefits.

conclusionsMRI scans can be effectively ordered based on the information provided by the primary care referral letter. Requesting MRI scans early in the patient journey can save considerable time, improve care, and deliver cost savings. These slides can be retrieved under Electronic Supplementary Material.

Indexed as

AdolescentAdultAgedAged, 80 and overCorrespondence as TopicEarly DiagnosisFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedPredictive Value of TestsPrimary Health CareProspective StudiesQuality ImprovementReferral and ConsultationGeneral practitionersMagnetic resonance imagingOutpatient departmentPatient careQuality improvementQuality of patient careSensitivitySpecificityStreamline patient journey

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Registered trials

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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.