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Research ArticleORIGINAL RESEARCH

General Practitioners’ Perspectives on Appropriate Use of Ultrasonography in Primary Care in Denmark: A Multistage Mixed Methods Study

Camilla Aakjær Andersen, Timothy C. Guetterman, Michael D. Fetters, John Brodersen, Annette Sofie Davidsen, Ole Graumann and Martin Bach Jensen
The Annals of Family Medicine May 2022, 20 (3) 211-219; DOI: https://doi.org/10.1370/afm.2795
Camilla Aakjær Andersen
1Center for General Practice at Aalborg University, Aalborg, Denmark
MD, PhD
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  • For correspondence: caakjaer@dcm.aau.dk
Timothy C. Guetterman
2Mixed Methods Program and Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
PhD, MA
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Michael D. Fetters
2Mixed Methods Program and Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
MD, MPH, MA
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John Brodersen
3Research Unit for General Practice and Section of General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
4Primary Health Care Research Unit, Region Zealand, Copenhagen, Denmark
MD, PhD
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Annette Sofie Davidsen
3Research Unit for General Practice and Section of General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
MD, PhD, DMSc
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Ole Graumann
5Department of Radiology, Radiological Research and Innovation Unit, Odense University Hospital, Odense, Denmark
MD, PhD
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Martin Bach Jensen
1Center for General Practice at Aalborg University, Aalborg, Denmark
MD, PhD
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Abstract

PURPOSE Researchers aimed to describe general practitioners’ understanding of appropriate ultrasound use, to record actual scanning practices of early adopters in general practice, and to identify differences between attitudes and actual practice via a mixed methods analysis.

METHODS This study was part of a larger multistage mixed methods research framework exploring the use of ultrasound in general practice in Denmark. We used an exploratory sequential approach in the data collection with initial qualitative findings from an interview study applied to building a quantitative questionnaire utilized in a cohort study. In addition, we merged the qualitative and quantitative data using joint display analysis to compare and contrast the results from the 2 stages of the study.

RESULTS In the interviews, general practitioners described appropriate ultrasound use as point-of-care examinations with a clear purpose and limited to predefined specific conditions within delimited anatomic areas. They stated that general practitioners should receive formalized ultrasound training and be skilled in the examinations they perform. In the cohort study, general practitioners performed ultrasound examinations of anatomic areas with or without a defined clinical suspicion. Some performed ultrasound examinations for which they had no previous training or skills.

CONCLUSIONS We found a difference between the ideas about the appropriate uses for ultrasound in general practice and the actual use by early adopters in clinical practice. Our findings suggest a need for evidence-based guidelines to support general practitioners in choosing which examinations to perform and strategies for developing and maintaining scanning competency.

Key words:
  • family practice
  • general practice
  • primary health care
  • point-of-care systems
  • ultrasonography
  • Received for publication October 22, 2020.
  • Revision received September 14, 2021.
  • Accepted for publication October 8, 2021.
  • © 2022 Annals of Family Medicine, Inc.
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The Annals of Family Medicine: 20 (3)
The Annals of Family Medicine: 20 (3)
Vol. 20, Issue 3
1 May 2022
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General Practitioners’ Perspectives on Appropriate Use of Ultrasonography in Primary Care in Denmark: A Multistage Mixed Methods Study
Camilla Aakjær Andersen, Timothy C. Guetterman, Michael D. Fetters, John Brodersen, Annette Sofie Davidsen, Ole Graumann, Martin Bach Jensen
The Annals of Family Medicine May 2022, 20 (3) 211-219; DOI: 10.1370/afm.2795

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General Practitioners’ Perspectives on Appropriate Use of Ultrasonography in Primary Care in Denmark: A Multistage Mixed Methods Study
Camilla Aakjær Andersen, Timothy C. Guetterman, Michael D. Fetters, John Brodersen, Annette Sofie Davidsen, Ole Graumann, Martin Bach Jensen
The Annals of Family Medicine May 2022, 20 (3) 211-219; DOI: 10.1370/afm.2795
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