文章基本信息

标题：Effectiveness of Gatekeepers in Determining the Appropriate Use of Brain MRI/MRA Tests
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作者：Seiji Bito ; Shinji Matsumura ; Kazuhiko Kotani 等
期刊名称：International Journal of Family Medicine
印刷版ISSN：2090-2042
电子版ISSN：2090-2050
出版年度：2014
卷号：2014
DOI：10.1155/2014/670915
出版社：Hindawi Publishing Corporation
摘要：The purpose of the study is to examine whether, among patients who visited hospitals and underwent brain MRI or MRA scan tests, there was a relationship between the existence of clinically significant abnormal findings and the relevance of primary care physicians’ referrals. A case-control study was carried out at six teaching hospitals in Japan. We identified cases with significant abnormal MRI/MRA findings from radiologists’ reports based on certain explicit criteria and controls with outpatients who underwent MRI/MRA scans but did not have stroke. We also collected clinical data independently from medical records. The findings of 156 cases and 721 controls were collected for the analysis. A multivariate analysis adjusted by age group, sex, and the number of comorbidity factors showed that those who had visited the hospitals after referral were more likely to have significant abnormal findings in their MRI/MRA scan results (odds ratio [OR] = 1.6, 95% CI: 1.1 to 2.4). The present study suggests that referral from gatekeepers such as primary care physicians is effective in determining the appropriate use of brain MRI/MRA tests for hospital outpatients.