Test ordering in an evidence free zone: Rates and associations of Australian general practice trainees’ vitamin D test ordering

Tapley, Amanda, Magin, Parker, Morgan, Simon, Henderson, Kim, Scott, John, Thomson, Allison, Spike, Neil, Mcarthur, Lawrie, van Driel, Mieke, McElduff, Patrick and Bonevski, Billie (2015) Test ordering in an evidence free zone: Rates and associations of Australian general practice trainees’ vitamin D test ordering. Journal of Evaluation in Clinical Practice, 21 6: 1151-1156. doi:10.1111/jep.12322

Attached Files (Some files may be inaccessible until you login with your UQ eSpace credentials)
Name Description MIMEType Size Downloads

Author Tapley, Amanda
Magin, Parker
Morgan, Simon
Henderson, Kim
Scott, John
Thomson, Allison
Spike, Neil
Mcarthur, Lawrie
van Driel, Mieke
McElduff, Patrick
Bonevski, Billie
Title Test ordering in an evidence free zone: Rates and associations of Australian general practice trainees’ vitamin D test ordering
Journal name Journal of Evaluation in Clinical Practice   Check publisher's open access policy
ISSN 1365-2753
1356-1294
Publication date 2015-12
Sub-type Article (original research)
DOI 10.1111/jep.12322
Volume 21
Issue 6
Start page 1151
End page 1156
Total pages 6
Place of publication West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2016
Language eng
Formatted abstract
Rationale, aims and objectives: Indiscriminate health screening is increasingly seen as being problematic. In particular, vitamin D testing rates are increasing rapidly despite recommendations against population screening. The purpose of this study was to determine the level of vitamin D testing among family practice/general practitioner (GP) trainees and to establish associations of this testing.

Methods: Cross-sectional analysis of data from the ReCEnT (Registrars Clinical Encounters in Training) cohort study. The setting was GP practices in four Australian states. Data from 60 consecutive consultations per trainee were recorded each 6-month training term (up to four terms).

Results: Vitamin D tests were ordered in 726 (1.0%) of encounters (n=69412). Vitamin D test ordering was significantly associated with patients being older, female and non-English speaking. Trainees were more likely to test if they worked in a completely bulk-billing practice (i.e. a practice without any patient payment), if more problems were dealt with, more pathology tests were ordered in the consultation and if a lipid profile was ordered. They were less likely to test if they sought in-consultation advice or information. The most common reasons for testing were 'check-up' and 'health maintenance'.

Conclusions: In this first report of associations of vitamin D testing in the GP setting, we found that non-targeted vitamin D testing (testing inconsistent with current guidelines) is widespread in GP trainees' practice. Adoption of more rational testing approaches is needed.
Keyword Education
Evidence-based medicine
Family practice
General practice
Testing
Trainees
Vitamin D
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 0 times in Scopus Article
Google Scholar Search Google Scholar
Created: Tue, 09 Jun 2015, 02:15:50 EST by System User on behalf of Scholarly Communication and Digitisation Service