{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T01:18:39Z","timestamp":1768007919112,"version":"3.49.0"},"reference-count":7,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,1,28]],"date-time":"2019-01-28T00:00:00Z","timestamp":1548633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthod"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Aims:<\/jats:title><jats:p> To assess the performance of the referral management system (RMS) compared to a previous paper-based referral system and to determine whether referrals reflected the patients\u2019 malocclusion and met current guidelines. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design:<\/jats:title><jats:p> Three-cycle audit. <\/jats:p><\/jats:sec><jats:sec><jats:title>Setting:<\/jats:title><jats:p> Orthodontic Department, Liverpool University Dental Hospital, UK. <\/jats:p><\/jats:sec><jats:sec><jats:title>Participants:<\/jats:title><jats:p> Consecutive new orthodontic patient referrals. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> Data were collected prospectively from orthodontic referral letters and new patient clinic proformas (2016\u20132017). Cycle 1 assessed the original paper-based referral form, Cycle 2 assessed the first RMS online form and Cycle 3 assessed a modified RMS form. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Cycles 1, 2 and 3 audited 83, 84 and 81 referrals, respectively. Agreement between the reason for referral and the new patient clinic findings was moderate for Cycles 1 and 3 (Kappa = 0.47 and 0.60, respectively) and fair for Cycle 2 (Kappa = 0.40). In Cycles 1, 2 and 3, the proportion of new patients appropriate for hospital orthodontic care reduced from 52% to 51% and 40%, respectively. None of the three cycles reached the 90% target for compliance with current referral guidelines. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> Cycle 3\u2019s RMS form gave a truer reflection of the patients\u2019 malocclusion but reduced the proportion of appropriate referrals. Further audit is required in this area to investigate the cost-effectiveness and clinical benefits of the RMS. <\/jats:p><\/jats:sec>","DOI":"10.1177\/1465312518824099","type":"journal-article","created":{"date-parts":[[2019,3,1]],"date-time":"2019-03-01T14:49:01Z","timestamp":1551451741000},"page":"39-45","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Orthodontic referral management systems: Do they make a difference?"],"prefix":"10.1177","volume":"46","author":[{"given":"Orla","family":"Carty","sequence":"first","affiliation":[{"name":"Department of Orthodontics, Liverpool University Dental Hospital and School of Dentistry, Pembroke Place, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henna","family":"Toor","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Liverpool University Dental Hospital and School of Dentistry, Pembroke Place, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy A","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Liverpool University Dental Hospital and School of Dentistry, Pembroke Place, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayne E","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Liverpool University Dental Hospital and School of Dentistry, Pembroke Place, Liverpool, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,1,28]]},"reference":[{"key":"bibr1-1465312518824099","unstructured":"British Orthodontic Society (2009) Guidelines for Referrals for Orthodontic Treatment. London: BOS."},{"key":"bibr2-1465312518824099","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp13X668177"},{"key":"bibr3-1465312518824099","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6856"},{"key":"bibr4-1465312518824099","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6855"},{"key":"bibr5-1465312518824099","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2009.979"},{"key":"bibr6-1465312518824099","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2016.377"},{"key":"bibr7-1465312518824099","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"}],"container-title":["Journal of Orthodontics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1465312518824099","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1465312518824099","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1465312518824099","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T08:29:34Z","timestamp":1740817774000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1465312518824099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,28]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1177\/1465312518824099"],"URL":"https:\/\/doi.org\/10.1177\/1465312518824099","relation":{},"ISSN":["1465-3125","1465-3133"],"issn-type":[{"value":"1465-3125","type":"print"},{"value":"1465-3133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,28]]}}}