Every year in the Netherlands, general practitioners (GPs) request an average of 500,000 chest X-rays and 200,000 abdominal ultrasounds. This makes these diagnostic tests the ones most frequently requested by GPs. In spite of their relatively low cost, this high frequency results in considerable expense and forms a burden for the health care system. In addition, the test is inconvenient for the patient and unnecessary tests can lead to chance findings and more tests. However, very little is known about the added value of chest X-rays and abdominal ultrasounds in patients referred by their GPs – not even for the most important indications, such as suspected pneumonia or gallstones.
Anouk Speets studied the clinical relevance of chest radiography and abdominal ultrasounds in general practice. Clinically relevant abnormalities were found in 24 percent of chest X-rays and 29 percent of the abdominal ultrasounds requested by GPs. The treatment proposed by GPs changed for 60 percent of the patients following chest radiography and in 64 percent following an abdominal ultrasound. As a result, the GPs referred fewer patients to medical specialists and prescribed fewer medicines and there were more reassured patients. So it appears that chest radiography and abdominal ultrasounds requested by GPs form a valuable addition to their diagnostics and treatment plans.
Anouk Speets
Chest radiography and abdominal ultrasound in general practice
PhD advisor 1: Prof. W.P.T.M. Mali
PhD advisor 2: Prof. A.W. Hoes
PhD advisor 3: Prof. Y. van der Graaf
Co-advisor: Dr. S. Kalmijn