Family Practice Advance Access originally published online on June 21, 2006
Family Practice 2006 23(5):507-511; doi:10.1093/fampra/cml027
Upper abdominal ultrasound in general practice: indications, diagnostic yield and consequences for patient management
a Department of Radiology, University Medical Centre Utrecht Utrecht, The Netherlands
b Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht Utrecht, The Netherlands
c Department of Radiology, ‘Onze Lieve Vrouwe Gasthuis’ Amsterdam, The Netherlands
d Department of Radiology, Gelre Hospitals Apeldoorn, The Netherlands
e Department of Radiology, Jeroen Bosch Hospital's-Hertogenbosch The Netherlands
Correspondence to Anouk M Speets, Department of Radiology, E01.335, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands; Email: a.speets{at}umcutrecht.nl
Background. Abdominal ultrasound (US) is frequently performed in Western societies. There is insufficient knowledge of its diagnostic value in terms of changes in patient management decisions in primary care.
Objective. To assess the influence of upper abdominal US on patient management in general practice.
Methods. A prospective cohort study with 76 GPs and three general hospitals in The Netherlands. A total of 395 patients aged 
18 years referred by their GPs for upper abdominal US were included. The main outcome was change in anticipated patient management assessed by means of questionnaires filled in by GPs before and after abdominal US.
Results. Mean age of the patients was 54.0 ± 15.8 years, 35% were male. Clinically relevant abnormalities were found in 29% of the abdominal US, mainly cholelithiasis. Anticipated patient management changed in 64% of the patients following abdominal US. Main changes included fewer referrals to a medical specialist (from 45 to 30%); and more frequent reassurance of the patient (from 15 to 43%). However, this reassurance was not perceived as such in almost 40% of these patients. A change in anticipated patient management occurred significantly more frequently in patients with a prior cholecystectomy (82%).
Conclusion. Anticipated patient management by the GP changed in 64% of patients following upper abdominal US. Abdominal US substantially reduced the number of intended referrals to a medical specialist, and more patients could be reassured by their GP.
Keywords. Abdominal ultrasound, general practice, patient care management.
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