Completed Research Project
Implementing Referral Guidelines in Colorectal Cancer; developing a complex intervention in general practice
Investigators: Jiwa M, Ee H, Saunders C.
Funding: R B Brown Bequest ($20,000)
Administering Institution: Curtin University
This study explored the impact of a variety of patient and respondent characteristics on doctors’ decision to refer patients with colorectal symptoms in two different health care systems.
A self-administered structured vignette postal survey of General Practitioners in Western Australia and the United Kingdom was used. Sixty-four vignettes describing patients with colorectal symptoms were constructed encompassing six clinical details. Nine vignettes, chosen at random, were presented to each individual. Respondents were asked if they would refer the patient to a specialist and how urgently.
Logistic regression and parametric tests were used to analyse the data.
We received 260 completed questionnaires. 58% of ‘cancer vignettes’ were selected for ‘urgent’ referral. 1632 / 2367 or 69% of all vignettes were selected for referral. After adjusting for clustering the model suggests that 38.4% of the variability is explained by all the clinical variables as well as the age and experience of the respondents. 1012 or 42.8 % of vignettes were referred ‘urgently’. After adjusting for clustering the data suggests that 31.3 % of the variability is explained by the model. The age of the respondents, the location of the practice and all the clinical variables were significant in the decision to refer urgently.
