{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T20:56:55Z","timestamp":1763499415704,"version":"3.45.0"},"reference-count":11,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":2882,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>AIMS<\/jats:title>\n                    <jats:p>Many transient ischaemic attack (TIA) patients receive initial assessments by general practitioners (GPs). In a randomised controlled trial (RCT) we showed that BPAC Inc. TIA\/stroke electronic decision support (EDS) for GPs improves patient outcomes and guideline adherence. This secondary analysis assesses the impact of trial associated enhanced GP access to radiological investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Post-hoc analysis of a multi-centre, single blind, parallel group, cluster RCT comparing TIA\/stroke EDS guided GP management with usual care to assess whether imaging requests and their appropriateness differed between study groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>GPs requested 15\/291 (5.2%) carotid ultrasounds and 19\/291 (6.5%) computed tomography (CT) head scans. Scans were obtained more frequently in the intervention group (ultrasound cluster adjusted OR (95% CI) 1.41 (0.44 to 4.49), P = 0.56 and CT 13.8 (1.7 to 110.7), P &amp;lt; 0.001). All CTs were clinically appropriate. More ultrasounds were appropriate in the EDS group (cluster adjusted OR (95% CI) of 8.4 (0.39 to 92.3), P = 0.18). Overall investigation costs did not differ between groups (P = 0.83). Some apparent avoidable imaging duplication occurred where patients were subsequently assessed by secondary services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In the setting of a RCT assessing GP electronic decision support, frequency of GP initiated imaging requests was low and largely appropriate especially in the setting of EDS use. Thus enhanced GP imaging access as part of the EDS tool did not result in inappropriate or excessive GP imaging requests. However, some duplication occurred and practitioners need to ensure that test referrals and results are adequately communicated between sectors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/hc17005","type":"journal-article","created":{"date-parts":[[2018,6,21]],"date-time":"2018-06-21T02:48:03Z","timestamp":1529549283000},"page":"131-135","source":"Crossref","is-referenced-by-count":3,"title":["Appropriateness of general practitioner imaging requests for transient ischaemic attack patients: secondary analysis  of a cluster randomised controlled trial"],"prefix":"10.1071","volume":"9","author":[{"given":"Annemarei","family":"Ranta","sequence":"first","affiliation":[{"name":"ADepartment of Medicine, University of Otago, Wellington, New Zealand"},{"name":"BDepartment of Neurology, Capital & Coast District Health Board, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Weatherall","sequence":"additional","affiliation":[{"name":"ADepartment of Medicine, University of Otago, Wellington, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Gommans","sequence":"additional","affiliation":[{"name":"CDepartment of Medicine, Hawke\u2019s Bay District Health Board, Hastings, New\u00a0Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murray","family":"Tilyard","sequence":"additional","affiliation":[{"name":"DDepartment of General Practice and Rural Health, University of Otago, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Des","family":"Odea","sequence":"additional","affiliation":[{"name":"BDepartment of Neurology, Capital & Coast District Health Board, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Dovey","sequence":"additional","affiliation":[{"name":"DDepartment of General Practice and Rural Health, University of Otago, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2017,6,30]]},"reference":[{"key":"2025111813455661900_R1","doi-asserted-by":"publisher","first-page":"a1569","DOI":"10.1136\/bmj.a1569","article-title":"Influence of general practice opening hours on delay in seeking medical attention after transient ischaemic attack (TIA) and minor stroke: Prospective population based study.","volume":"337","author":"Lasserson","year":"2008","journal-title":"BMJ"},{"issue":"1372","key":"2025111813455661900_R2","first-page":"25","article-title":"Who should manage transient ischemic attacks? 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A survey of radiologists\u2019 perceptions.","volume":"9","author":"Lysdahl","year":"2009","journal-title":"BMC Health Serv Res"},{"key":"2025111813455661900_R5","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/1748-5908-7-107","article-title":"Efficacy and safety of a tia\/stroke electronic support tool (fastest) trial: Study protocol.","volume":"7","author":"Ranta","year":"2012","journal-title":"Implement Sci"},{"key":"2025111813455661900_R6","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1212\/WNL.0000000000001472","article-title":"Cluster randomised controlled trial of tia electronic decision support in primary care.","volume":"84","author":"Ranta","year":"2015","journal-title":"Neurology"},{"key":"2025111813455661900_R7","unstructured":"NZ Guideline Group. New Zealand clinical guidelines for stroke management 2010. www.nzgg.org.nz. 2010."},{"key":"2025111813455661900_R8"},{"issue":"9596","key":"2025111813455661900_R9","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1016\/S0140-6736(07)61448-2","article-title":"Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (express study): A prospective population-based sequential comparison.","volume":"370","author":"Rothwell","year":"2007","journal-title":"Lancet"},{"issue":"10","key":"2025111813455661900_R10","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1212\/WNL.0000000000002339","article-title":"Transient ischemic attack service provision: A review of available service models.","volume":"86","author":"Ranta","year":"2016","journal-title":"Neurology"},{"key":"2025111813455661900_R11","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1016\/S1474-4422(07)70248-X","article-title":"A transient ischaemic attack clinic with round-the-clock access  (SOS-TIA): feasibility and effects.","volume":"6","author":"Lavall\u00e9e","year":"2007","journal-title":"Lancet Neurol"}],"container-title":["The Journal of Primary Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/hc\/article-pdf\/9\/2\/131\/222306\/hc17005.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/hc\/article-pdf\/9\/2\/131\/222306\/hc17005.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T18:46:02Z","timestamp":1763491562000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/hc\/article\/9\/2\/131\/34847\/Appropriateness-of-general-practitioner-imaging"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,30]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,6,30]]},"published-print":{"date-parts":[[2017,6,30]]}},"URL":"https:\/\/doi.org\/10.1071\/hc17005","relation":{},"ISSN":["1172-6156"],"issn-type":[{"type":"electronic","value":"1172-6156"}],"subject":[],"published":{"date-parts":[[2017,6,30]]}}}