
TY  - JOUR
A1  - Kara, Stephen 
A1  - Smart, Alexandra 
A1  - Officer, Tara 
A1  - Dassanayake, Chan 
A1  - Clark, Phil 
A1  - Smit, Amy 
A1  - Cavadino, Alana 
T1  - <i>Corrigendum to</i>: Guidelines, training and quality assurance: influence on general practitioner MRI referral quality
JF  - Journal of Primary Health Care
JO  - J Prim Health Care
Y1  - 2019
VL  - 11
IS  - 4
SP  - 387
EP  - 387
KW  - 
UR  - https://doi.org/10.1071/HC19034_CO 
N2  - ABSTRACT INTRODUCTIONMagnetic resonance imaging (MRI) is an accurate diagnostic test used mainly in secondary care. Uncertainty exists regarding the ability of general practitioners (GPs) to use direct access high-tech imaging pathways appropriately when managing musculoskeletal injury. AIMTo evaluate the use of primary care-centric guidelines, training and quality assurance on the appropriateness of GP MRI referrals for patients with selected musculoskeletal injuries. METHODSThis is an 18-month primary care retrospective study. GPs participated in clinical musculoskeletal training, enabling patient referral for MRI on four body sites. Two reviewers categorised referral appropriateness independently, and reviewer inter-rater agreement between categorisations was measured. MRI results and patient management pathways were described. Associations of scan status and patient management were examined using logistic regression. RESULTSIn total, 273 GPs from 72 practices attended training sessions to receive MRI referral accreditation. Of these, 150 (55%) GPs requested 550 MRI scans, with 527 (96%) eligible for analysis, resulting in 86% considered appropriate; 79% consistent with guidelines and 7% clinically useful but for conditions outside of guidelines. Inter-rater agreement was 75%. Cohen's weighted kappa statistic was 0.38 (95% CI: 0.28&#x2013;0.48). MRI referrals consistent with guidelines were more likely to show pathology requiring specialist intervention (reviewer 1: odds ratio=2.64, 95% CI 1.51&#x2013;4.62; reviewer 2: odds ratio=4.44, 95% CI 2.47&#x2013;7.99), compared to scan requests graded not consistent. DISCUSSIONStudy findings indicate GPs use decision support guidance well, and this has resulted in appropriate MRI referrals and higher specialist intervention rates for selected conditions. 
ER  -

