BMJ 1995;311:329 (29 July)

Letters

Guidelines to reduce x ray examinations in accident departments

Implementing guidelines may not improve outcome for patients

EDITOR,--Eugene McNally and colleagues report the effect of introducing guidelines on when to request radiographs for certain conditions presenting in an accident department.1 Two aspects of this paper merit discussion. Firstly, the outcome measured and the data presented do not seem to support the conclusions. Secondly, one should not infer that use of the posters containing the guidelines will lead to clinical benefit for patients.

The outcome measured (the proportion of patients referred for particular series of radiological views) is not the same as the proportion of patients managed in accordance with the guidelines. The follow up of patients who did not undergo radiography seems inadequate: the reduction in the proportion of patients undergoing radiography may have been inappropriate. The reduction need not have been due to fewer unnecessary radiographs being obtained.

In two of the areas studied (radiography of the cervical . . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Recent Advances: Posters for accident departments: simple method of sustaining reduction in x ray examinations
Eugene McNally, Gerald de Lacey, Philippa Lovell, and Theo Welch
BMJ 1995 310: 640-642. [Abstract] [Full Text]

Access jobs at BMJ Careers
Whats new online at Student BMJ