Abstract:
OBJECTIVE:To study delays between sending referral letters and the outpatient appointment and to assess the content of referral and reply letters, their educational value, and the extent to which questions asked are answered by reply letters. DESIGN:Retrospective review of referrals to 16 consultant orthopaedic surgeons at five hospitals, comprising 288 referral letters with corresponding replies, by scoring contents of letters. SETTING:Orthopaedic teaching hospitals in Nottingham, Derby, and Mansfield. MAIN OUTCOME MEASURES:Weighted scores of contents of referral and reply letters, assessment of their educational value, and responses to questions in referral letters. RESULTS:Median outpatient delay was 23.4 weeks. There was no significant decrease in waiting time if the referral letter was marked "urgent" but a significantly greater delay (p less than 0.01) if referrals were directed to an unnamed consultant. The content score was generally unsatisfactory for both referrals and replies, and there was no correlation for the content scores of the referral letter and its reply (r = 0.13). Items of education were rare in the referral letters (8/288; 3%) and significantly more common in replies (75/288; 26%) (p much less than 0.001). Senior registrars were significantly more likely to attempt education than other writers (p less than 0.02). Education in replies was significantly related to increased length of the letter (p less than 0.05) and was more likely to occur if the referral was addressed to a named consultant (p less than 0.03). 48 (17%) Referral letters asked questions, of which 21 (44%) received a reply. No factor was found to influence the asking of or replying to questions. CONCLUSIONS:The potential for useful communication in the referral letter and in the reply from orthopaedic surgeons is being missed at a number of levels. The content is often poor, the level of mutual education is low, and the use of the referral letter to determine urgency is deficient. Most questions asked by general practitioners are not answered.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Jacobs LG,Pringle MAdoi
10.1136/bmj.301.6750.470subject
Has Abstractpub_date
1990-09-08 00:00:00pages
470-3issue
6750eissn
0959-8138issn
1756-1833journal_volume
301pub_type
杂志文章abstract:OBJECTIVE:To test the hypothesis of an association between neonatal intramuscular vitamin K and childhood leukaemia and other cancers. DESIGN:Population based case-control study with data abstracted from hospital records. SETTING:Scotland. SUBJECTS:Children aged 0-14 years resident in Scotland from 1991-4 and diagno...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7126.173
更新日期:1998-01-17 00:00:00
abstract:OBJECTIVE:To assess the association between mind wandering (thinking unrelated to the task at hand) and the risk of being responsible for a motor vehicle crash. DESIGN:Responsibility case-control study. SETTING:Adult emergency department of a university hospital in France, April 2010 to August 2011. PARTICIPANTS:955...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e8105
更新日期:2012-12-13 00:00:00
abstract:OBJECTIVE:To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners. DESIGN:Multicentre randomised controlled trial. SETTING:Nine memory clinics and 159 general practitioners in the Netherlands. PARTICIPANTS:175 patients with a ne...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.e3086
更新日期:2012-05-15 00:00:00
abstract:OBJECTIVES:To identify the frequency with which antibiotics are prescribed in the absence of a documented indication in the ambulatory care setting, to quantify the potential effect on assessments of appropriateness of antibiotics, and to understand patient, provider, and visit level characteristics associated with ant...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.l6461
更新日期:2019-12-11 00:00:00
abstract:OBJECTIVE:To assess treatment related changes in quality of life up to 15 years after diagnosis of localised prostate cancer. DESIGN:Population based, prospective cohort study with follow-up over 15 years. SETTING:New South Wales, Australia. PARTICIPANTS:1642 men with localised prostate cancer, aged less than 70, an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m3503
更新日期:2020-10-07 00:00:00
abstract::Doctors and other health professionals in developing countries are missing out on relevant information about health. A lot of the information they need is available in the developed countries, and those who have it are happy to share it with them. But transporting information, like food or medicines, from one part of ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.309.6959.939
更新日期:1994-10-08 00:00:00
abstract:OBJECTIVE:To quantify the association between stressful life events and exacerbations of multiple sclerosis. DATA SOURCES:PubMed, PsychInfo, and Psychological Abstracts searched for empirical papers from 1965 to February 2003 with terms "stress", "trauma", and "multiple sclerosis". REVIEW METHODS:Three investigators ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.38041.724421.55
更新日期:2004-03-27 00:00:00
abstract:OBJECTIVES:To determine whether informed consent introduces selection bias in prospective observational studies using data from medical records, and consent rates for such studies. DESIGN:Systematic review. DATA SOURCES:Embase, Medline, and the Cochrane Library up to March 2008, reference lists from pertinent article...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.b866
更新日期:2009-03-12 00:00:00
abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6982.768
更新日期:1995-03-25 00:00:00
abstract:OBJECTIVES:To describe utilisation of general practitioners by elderly people resident in communal establishments; to examine variations in general practitioner utilisation and estimate the likely impact of the "downsizing" of long stay provision in NHS hospitals. DESIGN:Secondary analyses of the survey of disability ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7154.322
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:To assess the association between macrolide antibiotics prescribing during pregnancy and major malformations, cerebral palsy, epilepsy, attention deficit hyperactivity disorder, and autism spectrum disorder in children. DESIGN:Population based cohort study. SETTING:The UK Clinical Practice Research Datalink...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m331
更新日期:2020-02-19 00:00:00
abstract::IgG4 related disease was recognized as a unified disease entity only 15 years ago. Awareness of IgG4 related disease has increased worldwide since then, and specialists are now familiar with most of its clinical manifestations. Involvement of the pancreato-biliary tract, retroperitoneum/aorta, head and neck, and saliv...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.m1067
更新日期:2020-06-16 00:00:00
abstract:OBJECTIVE:To evaluate the association between migraine and cognitive decline among women. DESIGN:Prospective cohort study. SETTING:Women's Health Study, United States. PARTICIPANTS:6349 women aged 65 or older enrolled in the Women's Health Study who provided information about migraine status at baseline and particip...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e5027
更新日期:2012-08-08 00:00:00
abstract::Several forces have resulted in the creation in Tayside of the first formally integrated unit of undergraduate and postgraduate education in general practice in the United Kingdom. Forces that helped this integration included the desire for change, national developments in education, financial support through funds se...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6994.1577
更新日期:1995-06-17 00:00:00
abstract:OBJECTIVES:To determine the association between ambulance response time and survival from out of hospital cardiopulmonary arrest and to estimate the effect of reducing response times. DESIGN:Cohort study. SETTING:Scottish Ambulance Service. SUBJECTS:All out of hospital cardiopulmonary arrests due to cardiac disease ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.322.7299.1385
更新日期:2001-06-09 00:00:00
abstract:OBJECTIVES:To evaluate current processes by which young children presenting with a febrile illness but suspected of having serious bacterial infection are diagnosed and treated, and to develop and test a multivariable model to distinguish serious bacterial infections from self limiting non-bacterial illnesses. Design T...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c1594
更新日期:2010-04-20 00:00:00
abstract:OBJECTIVE:To determine whether the more intensive screening and treatment for prostate cancer in the Seattle-Puget Sound area in 1987-90 led to lower mortality from prostate cancer than in Connecticut. DESIGN:Natural experiment comparing two fixed cohorts from 1987 to 1997. SETTING:Seattle-Puget Sound and Connecticut...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.325.7367.740
更新日期:2002-10-05 00:00:00
abstract:OBJECTIVE:To determine if the Food Standards Agency nutrient profiling system (FSAm-NPS), which grades the nutritional quality of food products and is used to derive the Nutri-Score front-of-packet label to guide consumers towards healthier food choices, is associated with mortality. DESIGN:Population based cohort stu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m3173
更新日期:2020-09-16 00:00:00
abstract:OBJECTIVE:To appraise a new method of prenatal screening for Down's syndrome based on maternal serum concentrations of alpha fetoprotein, unconjugated oestriol, and human chorionic gonadotrophin combined with maternal age--the "triple test." DESIGN:Examination of the cost effectiveness of the triple test relative to s...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.302.6785.1133
更新日期:1991-05-11 00:00:00
abstract:OBJECTIVE:To determine whether failure to adequately adjust for a reported 40% misclassification of use of in vitro fertilisation (IVF) as reported in a Swedish study could have led to a false finding that folic acid increases dizygotic twinning. DESIGN:Modelling with population based data. SETTING:Swedish vital reco...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38369.437789.82
更新日期:2005-04-09 00:00:00
abstract:OBJECTIVE:To accurately measure the incidence of gastric cancer among patients with gastric precancerous lesions, and to quantify the excess incidence in comparison with people with normal mucosa on endoscopy and a general population. DESIGN:Population based cohort study. SETTING:Population of Sweden using data from ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3867
更新日期:2015-07-27 00:00:00
abstract:OBJECTIVE:To evaluate the cost effectiveness of acupuncture in the management of chronic headache. DESIGN:Cost effectiveness analysis of a randomised controlled trial. SETTING:General practices in England and Wales. PARTICIPANTS:401 patients with chronic headache, predominantly migraine. Interventions Patients were ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.38033.896505.EB
更新日期:2004-03-27 00:00:00
abstract:OBJECTIVE:To compare the risk of detention under the Mental Health Act 1983 in a representative group of people with psychotic disorders from different ethnic groups. SETTING:Two defined geographical areas in south London. DESIGN:Annual period prevalent cases of psychosis were identified in 1993 in the study areas fr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7030.533
更新日期:1996-03-02 00:00:00
abstract:OBJECTIVE:To evaluate systematically the review literature on type 2 diabetes to assess transmission of the findings of the United Kingdom prospective diabetes study (UKPDS), an important source of recent valid patient oriented evidence that matters (POEMs). DESIGN:Inception cohort analysis of the recent medical liter...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.327.7409.266
更新日期:2003-08-02 00:00:00
abstract:OBJECTIVE:To determine the relation between mothers' self reported drinking habits before, during, and after pregnancy and infants' mental and motor development at 18 months of age. DESIGN:Follow up study of all singleton live births born to primigravidas living in Dundee and booked into antenatal clinics from 1 May 1...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.303.6793.22
更新日期:1991-07-06 00:00:00
abstract:OBJECTIVES:To compile a register of diabetic patients within the catchment area of a district general hospital and evaluate the characteristics of the population using aggregated data from a general practice audit. DESIGN:Cross sectional study. Practices identified all known diabetics and completed a questionnaire fro...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.307.6911.1046
更新日期:1993-10-23 00:00:00
abstract:OBJECTIVES:To investigate whether sending patients a copy of their referral letter can reduce non-attendance at outpatient departments. DESIGN:Blinded randomised controlled trial. SETTING:13 general practices in Exeter, Devon. SUBJECTS:2078 new consultant referrals from 26 doctors. MAIN OUTCOME MEASURES:Non-attenda...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.318.7195.1392
更新日期:1999-05-22 00:00:00
abstract:OBJECTIVE:To investigate the effect of immediate feedback from a point of care test for salivary nicotine metabolites in promoting smoking cessation and reduction in tobacco use. DESIGN:Prospective, operator blinded, randomised controlled trial. SETTING:General dental practice, London. PARTICIPANTS:100 adult smokers...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.38621.463900.7C
更新日期:2005-10-29 00:00:00
abstract:OBJECTIVE:To evaluate the primary care communications initiative, which introduced NHSnet to primary care in Scotland. DESIGN:Semi-structured telephone interviews, postal questionnaire. SETTING:All 15 Scottish health boards, random sample of 1 in 3 of all Scottish general practices. PARTICIPANTS:Information manageme...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7265.878
更新日期:2000-10-07 00:00:00
abstract:OBJECTIVE:To investigate the effects of the home environment on the risk of severe asthma during adolescence. DESIGN:A questionnaire based case-control study drawn from a cross sectional survey of allergic diseases among secondary school pupils in Sheffield in 1991. SUBJECTS:763 children whose parents had reported th...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7012.1053
更新日期:1995-10-21 00:00:00