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How do general practitioners respond to reports of abnormal chest X-rays?
W S Lim1, J T Macfarlane, P C Deegan
1Nottingham City Hospital, UK.
Journal of the Royal Society of Medicine
|January 25, 2000
Summary
General practitioners in the UK utilize chest X-rays (CXRs) for patient diagnosis. While GPs act on abnormal CXR results, timely hospital follow-up for suspected cancers, particularly within two weeks, remains a challenge, indicating potential for improved referral pathways.
Area of Science:
- Radiology
- General Practice
- Respiratory Medicine
Background:
- General practitioners (GPs) in the UK have direct access to hospital radiological services, aiming to expedite investigations and enhance service quality.
- Chest X-rays (CXRs) represent a significant portion of GP-requested imaging studies.
Purpose of the Study:
- To investigate the outcomes of abnormal chest X-ray (CXR) findings in patients referred by general practitioners (GPs).
- To assess the timeliness of hospital follow-up for critical CXR abnormalities, particularly those suspicious of malignancy.
Main Methods:
- Retrospective analysis of 605 chest X-ray (CXRs) requests made by 204 general practitioners (GPs) in the Nottingham area over one year.
- Categorization of CXR reports into normal, abnormal without indicated follow-up, and abnormal with indicated radiological follow-up or hospital referral.
- Tracking of hospital attendance for patients with abnormal CXRs requiring further investigation.
Main Results:
- Of 605 CXRs, 362 were normal, 165 abnormal but requiring no hospital follow-up, and 71 abnormal with indicated follow-up.
- 64 out of 71 patients with indicated follow-up were seen in hospital within three months.
- For suspected cancers (27 cases), the median time to hospital follow-up was 20 days, with only 37% seen within the recommended two weeks.
Conclusions:
- General practitioners (GPs) do act upon abnormal chest X-ray (CXR) findings.
- Adherence to recommended two-week hospital follow-up for suspected lung cancer following CXR requires improvement.
- Direct referral from radiology departments to respiratory physicians could potentially streamline patient care and reduce investigation times.
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