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Smoothing the passage of patients from primary care to specialist respiratory opinion

O'Byrne, Louise; Darlow, Camilla; Roberts, Nicola; Wilson, Graeme; Partridge, Martyn R.


Louise O'Byrne

Camilla Darlow

Graeme Wilson

Martyn R. Partridge


To assess whether information in general practitioner (GP) referral letters provides a basis for selection of diagnostic tests in patients referred for specialist respiratory advice.

We undertook a prospective study within a respiratory outpatients department to compare the diagnostic tests planned at three stages of the referral/specialist consultation process: i) using the GP referral letter alone; ii) using the referral letter and patient history; iii) using the referral letter, patient history, and clinical examination.

Analysis of the content of GP referral letters revealed wide variations in referral information. A high proportion of tests selected using the referral letter alone were altered after specialist history-taking and examination. Far fewer changes were recorded between history-taking and examination.

Neither literature review nor our study support a system which bases diagnostic test selection on GP referral letters alone. However, our findings suggest that approaches which include specialist history-taking in advance of face-to-face consultation merit further investigation.

Journal Article Type Article
Acceptance Date Mar 23, 2010
Online Publication Date May 14, 2010
Publication Date 2010-09
Deposit Date Aug 30, 2022
Journal Primary Care Respiratory Journal
Print ISSN 1471-4418
Electronic ISSN 1475-1534
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 19
Issue 3
Pages 248-253
Public URL