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Eur J Gen Pract. 2009;15(1):22-8. doi: 10.1080/13814780902855762.

What makes general practitioners order blood tests for patients with unexplained complaints? A cross-sectional study.

Author information

1
Division of Clinical Methods and Public Health, Department of General Practice, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands. h.koch@amc.uva.nl

Abstract

BACKGROUND:

Approximately 13% of consultations in general practice involve patients with unexplained complaints (UCs). These consultations often end with general practitioners (GPs) ordering blood tests of questionable diagnostic informativeness.

OBJECTIVE:

We studied factors potentially associated with GPs' decisions to order blood tests.

METHODS:

Cross-sectional study. Twenty-seven GPs completed registration forms after each consultation concerning newly presented UCs.

RESULTS:

Of the 100 analysable patients, 59 had at least one blood test ordered. The median number of ordered tests was 10 (interpercentile range [IPR-90] 2-15). Compared to abdominal complaints, the blood test ordering (BTO) probability for fatigue was five times higher (relative risk [RR] 5.2). Duration of complaints for over 4 weeks also increased this probability (RR 1.6). Factors associated with a lower BTO probability were: likelihood of background psychosocial factors (RR 0.4) and GPs having a syndrome rather than symptom type of working hypothesis (RR 0.5).

CONCLUSION:

We found a high rate of BTO among GPs confronted with patients with UCs. Furthermore, a considerable number of tests were ordered. The selectivity in BTO behaviour of GPs can be improved upon.

PMID:
19363746
DOI:
10.1080/13814780902855762
[Indexed for MEDLINE]

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