Influence of magnetic resonance imaging of the knee on GPs' decisions: a randomised trial



DAMASK:(Direct Access to Magnetic Resonance Imaging: Assessment for Suspect Knees) Trial Team

S. Brealey; B. Cross; V. Morton; D.J. Torgerson; H. Cox; S. Coulton

Influence of magnetic resonance imaging of the knee on GPs' decisions: a randomised trial DAMASK:(Direct Access to Magnetic Resonance Imaging: Assessment for Suspect Knees) Trial Team

S. Brealey, B. Cross, V. Morton, D.J. Torgerson, H. Cox, S. Coulton

Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Background Magnetic resonance imaging (MRI) of the knee for meniscus and ligament injuries is an accurate diagnostic test. Early and accurate diagnosis of patients with knee problems may prevent the onset of chronic problems such as osteoarthritis, a common cause of disability in older people consulting their GP. Aim To assess the effect of early access to MRI, compared with referral to an orthopaedic specialist, on GPs' diagnoses and treatment plans for patients with knee problems. Design of Study A multicentre, pragmatic, randomised controlled trial. Setting Five hundred and fifty-three patients with knee problems were recruited from 163 general practices across the UK from November 2002 to October 2004. Method Eligible patients were randomised to MRI or consultation with an orthopaedic specialist. GPs made a concomitant provisional referral to orthopaedics for patients who were allocated to imaging. GPs recorded patients' diagnoses, treatment plans, and their confidence in these decisions at trial entry and follow-up. Data were analysed as intention to treat. Results There was no significant difference between MRI and orthopaedic groups for changes in diagnosis (P = 0.79) or treatment plans (P = 0.059). Significant changes in diagnostic and therapeutic confidence were observed for both groups with a greater increase in diagnostic confidence (P

Original language	English
Pages (from-to)	622-629
Number of pages	7
Journal	British Journal of General Practice
Volume	57
Issue number	541
Publication status	Published - Aug 2007

Cite this

@article{92a8cb74e4d741e68f70bf1ac826dce9,

title = "Influence of magnetic resonance imaging of the knee on GPs' decisions: a randomised trial DAMASK:(Direct Access to Magnetic Resonance Imaging: Assessment for Suspect Knees) Trial Team",

abstract = "Background Magnetic resonance imaging (MRI) of the knee for meniscus and ligament injuries is an accurate diagnostic test. Early and accurate diagnosis of patients with knee problems may prevent the onset of chronic problems such as osteoarthritis, a common cause of disability in older people consulting their GP. Aim To assess the effect of early access to MRI, compared with referral to an orthopaedic specialist, on GPs' diagnoses and treatment plans for patients with knee problems. Design of Study A multicentre, pragmatic, randomised controlled trial. Setting Five hundred and fifty-three patients with knee problems were recruited from 163 general practices across the UK from November 2002 to October 2004. Method Eligible patients were randomised to MRI or consultation with an orthopaedic specialist. GPs made a concomitant provisional referral to orthopaedics for patients who were allocated to imaging. GPs recorded patients' diagnoses, treatment plans, and their confidence in these decisions at trial entry and follow-up. Data were analysed as intention to treat. Results There was no significant difference between MRI and orthopaedic groups for changes in diagnosis (P = 0.79) or treatment plans (P = 0.059). Significant changes in diagnostic and therapeutic confidence were observed for both groups with a greater increase in diagnostic confidence (P",

author = "S. Brealey and B. Cross and V. Morton and D.J. Torgerson and H. Cox and S. Coulton",

year = "2007",

month = aug,

language = "English",

volume = "57",

pages = "622--629",

journal = "British Journal of General Practice",

issn = "0960-1643",

publisher = "Royal College of General Practitioners",

number = "541",

}

Influence of magnetic resonance imaging of the knee on GPs' decisions: a randomised trial DAMASK:(Direct Access to Magnetic Resonance Imaging: Assessment for Suspect Knees) Trial Team. / Brealey, S.; Cross, B.; Morton, V. et al.
In: British Journal of General Practice, Vol. 57, No. 541, 08.2007, p. 622-629.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Influence of magnetic resonance imaging of the knee on GPs' decisions: a randomised trial DAMASK:(Direct Access to Magnetic Resonance Imaging: Assessment for Suspect Knees) Trial Team

AU - Brealey, S.

AU - Cross, B.

AU - Morton, V.

AU - Torgerson, D.J.

AU - Cox, H.

AU - Coulton, S.

PY - 2007/8

Y1 - 2007/8

N2 - Background Magnetic resonance imaging (MRI) of the knee for meniscus and ligament injuries is an accurate diagnostic test. Early and accurate diagnosis of patients with knee problems may prevent the onset of chronic problems such as osteoarthritis, a common cause of disability in older people consulting their GP. Aim To assess the effect of early access to MRI, compared with referral to an orthopaedic specialist, on GPs' diagnoses and treatment plans for patients with knee problems. Design of Study A multicentre, pragmatic, randomised controlled trial. Setting Five hundred and fifty-three patients with knee problems were recruited from 163 general practices across the UK from November 2002 to October 2004. Method Eligible patients were randomised to MRI or consultation with an orthopaedic specialist. GPs made a concomitant provisional referral to orthopaedics for patients who were allocated to imaging. GPs recorded patients' diagnoses, treatment plans, and their confidence in these decisions at trial entry and follow-up. Data were analysed as intention to treat. Results There was no significant difference between MRI and orthopaedic groups for changes in diagnosis (P = 0.79) or treatment plans (P = 0.059). Significant changes in diagnostic and therapeutic confidence were observed for both groups with a greater increase in diagnostic confidence (P

AB - Background Magnetic resonance imaging (MRI) of the knee for meniscus and ligament injuries is an accurate diagnostic test. Early and accurate diagnosis of patients with knee problems may prevent the onset of chronic problems such as osteoarthritis, a common cause of disability in older people consulting their GP. Aim To assess the effect of early access to MRI, compared with referral to an orthopaedic specialist, on GPs' diagnoses and treatment plans for patients with knee problems. Design of Study A multicentre, pragmatic, randomised controlled trial. Setting Five hundred and fifty-three patients with knee problems were recruited from 163 general practices across the UK from November 2002 to October 2004. Method Eligible patients were randomised to MRI or consultation with an orthopaedic specialist. GPs made a concomitant provisional referral to orthopaedics for patients who were allocated to imaging. GPs recorded patients' diagnoses, treatment plans, and their confidence in these decisions at trial entry and follow-up. Data were analysed as intention to treat. Results There was no significant difference between MRI and orthopaedic groups for changes in diagnosis (P = 0.79) or treatment plans (P = 0.059). Significant changes in diagnostic and therapeutic confidence were observed for both groups with a greater increase in diagnostic confidence (P

M3 - Article

SN - 0960-1643

VL - 57

SP - 622

EP - 629

JO - British Journal of General Practice

JF - British Journal of General Practice

IS - 541

ER -