What makes general practitioners order blood tests for patients with unexplained complaints? A cross-sectional study

被引：18

作者：

Koch, Helen ^{[1
]}

van Bokhoven, Marloes A. ^{[3
]}

ter Riet, Gerben ^{[1
,2
]}

Hessels, Kirsten M. ^{[3
]}

van der Weijden, Trudy ^{[3
]}

Dinant, Geert-Jan ^{[3
]}

Bindels, Patrick J. E. ^{[1
]}

机构：

[1] Univ Amsterdam, Div Clin Methods & Publ Hlth, Dept Gen Practice, Acad Med Ctr, NL-1100 DD Amsterdam, Netherlands

[2] Univ Zurich, Horten Ctr, Zurich, Switzerland

[3] Univ Maastricht, Dept Gen Practice, Care & Publ Hlth Res Inst CAPHRI, Maastricht, Netherlands

来源：

EUROPEAN JOURNAL OF GENERAL PRACTICE | 2009年 / 15卷 / 01期

关键词：

Blood test ordering; unexplained complaints; determinants; cross-sectional study;

D O I：

10.1080/13814780902855762

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: Approximately 13% of consultations in general practice involve patients with unexplained complaints (UCs). These consultations often end with general practitioners (GPs) ordering blood tests of questionable diagnostic informativeness. Objective: We studied factors potentially associated with GPs' decisions to order blood tests. Methods: Cross-sectional study. Twenty-seven GPs completed registration forms after each consultation concerning newly presented UCs. Results: Of the 100 analysable patients, 59 had at least one blood test ordered. The median number of ordered tests was 10 (interpercentile range [IPR-90] 2-15). Compared to abdominal complaints, the blood test ordering (BTO) probability for fatigue was five times higher (relative risk [RR] 5.2). Duration of complaints for over 4 weeks also increased this probability (RR 1.6). Factors associated with a lower BTO probability were: likelihood of background psychosocial factors (RR 0.4) and GPs having a syndrome rather than symptom type of working hypothesis (RR 0.5). Conclusion: We found a high rate of BTO among GPs confronted with patients with UCs. Furthermore, a considerable number of tests were ordered. The selectivity in BTO behaviour of GPs can be improved upon.

引用

页码：22 / 28

页数：7

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