Evidence map›Paper›PMID 36456003›Full record

ArticleBMJ open2022

Impact of digital interdisciplinary consultation on secondary care referrals by general practitioners: a protocol for a stepped-wedge cluster randomised controlled trial.

Sanne Sanavro, Henk van der Worp, Danielle Jansen, Joke Stoffelen, Henk Schers, Maarten Postma, Paul Koning, Michiel de Boer, Guus Janus, Marco H Blanker

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Trial
  2. Article
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

10 authors.

Sanne SanavroDepartment General Practice and Elderly Care Medicine, University of Groningen, University medical center groningen, Groningen, The Netherlands s.m.sanavro@umcg.nl.ORCID 0000-0002-6785-3302
Henk van der WorpDepartment General Practice and Elderly Care Medicine, University of Groningen, University medical center groningen, Groningen, The Netherlands.ORCID 0000-0001-5545-4155
Danielle JansenDepartment General Practice and Elderly Care Medicine, University of Groningen, University medical center groningen, Groningen, The Netherlands.ORCID 0000-0002-2654-1038
Joke StoffelenZorgbelang Inclusief, Arnhem, The Netherlands.
Henk SchersDepartment of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands.ORCID 0000-0002-9362-9451
Maarten PostmaPharmacoepidemiology and Pharmacoeconomics, University of Groningen, Groningen, The Netherlands.
Paul KoningSiilo Holding BV, Amsterdam, The Netherlands.
Michiel de BoerDepartment General Practice and Elderly Care Medicine, University of Groningen, University medical center groningen, Groningen, The Netherlands.
Guus JanusDepartment of Orthopaedic surgery, Isala hospital and Isala movement clinic, Zwolle, The Netherlands.
Marco H BlankerDepartment General Practice and Elderly Care Medicine, University of Groningen, University medical center groningen, Groningen, The Netherlands.ORCID 0000-0002-1086-8730

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOptimal collaboration between general practice and hospital care is crucial to maintain affordable and sustainable access to healthcare for the entire population. General practitioners (GPs) are the gatekeepers to specialist care and patients will visit hospitals mostly only after referral. However, a substantial part of these referrals may be inappropriate, as communication between GPs and medical specialists can be challenging and referring patients may be the most obvious action for a GP to perform.A new digital platform (Prisma) connects GPs and specialists in interdisciplinary groups and facilitates asynchronous, accessible and fast teleconsultation within the group. No previous research has been done to evaluate the impact of this new platform on the referral rates to the hospital. METHODS AND ANALYSIS: A stepped-wedge randomised controlled trial (RCT) will be performed in Zwolle region in the Netherlands to analyse the effect of introduction of the platform on rate of inappropriate referrals to orthopaedic surgery. In four steps, GPs in the region will be given access to the platform. GPs will be part of the control condition until randomisation to the intervention. According to our sample size calculation, we need to include 18 practices with 1008 patients presenting with hip and knee symptoms. Routine care data of hospital registrations will be analysed to calculate the rate of inappropriate referrals (primary outcome). Secondary outcome are costs, primary and secondary care workload, posted cases and user satisfaction. Alongside this quantitative analysis, we will evaluate patient experience, facilitators and barriers for use of the platform. ETHICS AND DISSEMINATION: The medical ethics review board of University Medical Center Groningen (UMCG), the Netherlands (METc-number: 2021/288) has confirmed that the Medical Research Involving Human Subjects Act (WMO) does not apply to the process evaluation because the study does not involve randomisation of patients or different medical treatments (letter number: M21.275351). TRIAL REGISTRATION NUMBER: NL9704.

Indexed as

General PracticeGeneral PractitionersRemote ConsultationHumansInterdisciplinary StudiesRandomized Controlled Trials as TopicSecondary Health Careeducation & training (see medical education & training)orthopaedic & trauma surgeryprimary caresports medicinetelemedicine

Identifiers

PMID36456003
PMCPMC9716832

What OpenQuestion holds

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Registered trials

None linked

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.