Reducing Overuse of Diagnostic Imaging – Project report
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The aim of the Reducing Overuse of Diagnostic Imaging Project is to promote the clinically relevant use of diagnostic imaging and assists GPs to reduce the potential for unintended harm to patients from unnecessary exposure to ionising radiation and identification of incidental findings that may lead to unnecessary treatment.
GPs play an important role in ensuring diagnostic imaging is used appropriately. Some types of diagnostic imaging have been identified as being particularly at risk of overuse. These include: lumbosacral spine X-ray and CT scan; cervical spine X-ray, CT scan, and MRI; shoulder X-ray and ultrasound; knee X-ray; hip X-ray and ultrasound; and ankle/hind foot ultrasound.
In November 2019 and November 2020, the Australian Government Chief Medical Officer wrote to approximately 3,000 GPs whose requesting rates of these diagnostic imaging tests was in the top 20% Australia-wide. Their requesting rate over the following 18 months was then compared with a control group of similarly high requesters of diagnostic imaging who did not receive a letter. The letter used percentiles to show GPs how their requesting rate compared to their peers in similar geographic areas.
The intent of the letter was to encourage GPs to reflect on their requesting behaviour. It also encouraged GPs to look for opportunities to reduce their use of diagnostic imaging, where safe and clinically indicated. The letters themselves did not indicate that recipients were engaging in inappropriate requesting. They simply showed how their requesting rate compared to their peers. The letters also noted that a GP’s requesting may be appropriate for their patient group.