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[caption id="attachment_5130" align="alignright" width="200"] Head x-ray, brain in MRI[/caption]
A 45 per cent rise in diagnostic imaging tests ordered by Australian GPs is being driven by increasing GP visits, a rising number of problems managed at consultations and a higher likelihood that GPs order imaging tests for these problems, according to a new聽University of Sydney study聽released today.
Based on a long term national survey of 9,802 GPs between 2002 and 2012, the report draws on data from more than 980,000 GP-patient encounter records to assess the extent to which GP鈥檚 order tests in line with diagnostic imaging guidelines.
鈥淢ost imaging tests ordered by GPs comply with expert guidelines,鈥� says the report鈥檚 lead author,聽Britt. 鈥淗owever, the study indicates that GPs are too quick to order imaging tests during their initial assessment of back problems. GPs are twice as likely to order an imaging test during the initial examination of new back-problems compared to follow-up consultations.
鈥淓xpert guidelines advise caution in ordering tests for presenting back problems unless there is a 鈥榬ed flag鈥� to prompt investigation,鈥� says Dr Britt. 鈥溾�楻ed flags鈥� can include issues such as major trauma, unexplained weight loss, unexplained fever, history of malignancy, inflammatory conditions and neurological issues. However, patients with 鈥榬ed flags鈥� account for a small proportion of people presenting with new back problems.鈥�
Overall, diagnostic radiology (plain x-rays) was the test type most frequently ordered by GPs (54 per cent), followed by computerised tomography (36 per cent),聽magnetic resonance imaging聽(5 per cent) and ultrasound (3 per cent).聽The study also notes a trend away from diagnostic radiology to CT and MRI orders, in line with changing recommendations in the guidelines.
The four strongest predictors of whether GPs order a diagnostic imaging test are:

• 路聽聽聽聽聽聽聽聽聽Number of problems managed at the GP-visit 鈥� each additional problem managed increases the probability of testing by 41 per cent.


• 路聽聽聽聽聽聽聽聽聽Type of medical problem managed 鈥� particularly musculoskeletal problems, female genital issues, pregnancy and family planning issues.


• 路聽聽聽聽聽聽聽聽聽Patient characteristics 鈥� females, those aged 45 years and older, and new patients.


• 路聽聽聽聽聽聽聽聽聽GP characteristics 鈥� women, GPs aged 35-44 years, those in solo practice, and those in a practice co-located with an imaging service.

聽will be launched today by Dr Megan Keaney 鈥� Assistant Secretary, Medical Specialist Services Branch, Medical Benefits Division, Australian Government Department of Health at the聽聽, National Convention Centre, Canberra.