An audit of general practitioner requests for pelvic ultrasound: analysis of referral patterns and outcome

Objectives 1. To assess the information supplied by general practitioners on the gynaecological ultrasound request form and to determine how this information influences the interpretation of scans; and 2. To examine the influence of scans on the subsequent management of patients both by general practitioners and, where relevant, by hospital gynaecologists. Design Retrospective analysis of gynaecological ultrasound requests made by general practitioners. Postal questionnaire and assessment of outcome according to general practitioners' records and, where appropriate, the hospital notes. Setting A London teaching hospital gynaecological ultrasound department and associated general practices. Subjects Four hundred ninety‐eight women referred by general practitioners for a gynaecological ultrasound scan over a one year period (1990). Results The 498 requests for gynaecological ultrasound scans included 472 primary diagnostic referrals. Seventy‐one percent of general practitioners replied to the questionnaires. Overall, 46% of the scans were normal, but the proportion of normal scans fell to 21% if the date of the last menstrual period and a pregnancy test result were included on the form. Forty per cent of women scanned subsequently were referred for hospital care. Conclusions General practitioners would appear to use the ultrasound service in a rational way and therefore there can be no justification for not allowing them open access. The positive diagnostic yield can be further improved if time is taken to supply simple relevant information which may be facilitated by a specific request form.