General practitioners’ and radiologists’ expectations regarding ankle radiography for chronic complaints in primary care

Context: Ankle complaints are a frequent reason to consult the general practitioner. The incidence of ankle complaints in primary care was 7.6 per 1000 persons in 2021. Our former research found that approximately 25% of the referral requests for ankle radiography were for chronic complaints. It is unknown what general practitioners and radiologists expect from radiographs for chronic ankle complaints, regarding reasons for referral requests, results, and communication between each other.

Objective: To explore the expectations of general practitioners and radiologists regarding radiographs for chronic ankle complaints.

Study Design and Analysis: A qualitative study was conducted, using semi-structured focus group interviews. The recorded interviews were transcribed and subsequently coded inductively and deductively in Max-QDA.

Setting: Five focus groups with general practitioners (group size: 2-6) and two focus groups with radiologists (group size: 3-5) were held live at the research, general practice, or radiology department, or online.

Population Studied: 25 General practitioners and 8 radiologists.

Instrument: The interview guide for general practitioners included the following topics: the reasons for referral requests, the content of the referral requests, the radiology reports, and the impact of the results on the patient and further action (e.g. testing, treatment, referral, consult and/or education). The content of the referral requests and radiology reports were also discussed with radiologists. Elaboration on other topics was allowed during the focus groups.

Outcome Measures: Subthemes and themes based on the coded transcripts.

Results: The following themes have been identified: medical, communication, patient-related, physician-related, and organizational. More detailed results will be available at the conference.

Conclusions: The outcomes will provide an insight into the rationale of general practitioners behind radiography referral requests for chronic ankle complaints, and in their expectations of the results. Moreover, differences and agreements between the expectations of general practitioners and radiologists regarding the reasons for referral requests, the content of the referral requests, and the radiology report will be revealed. This study will lead to practical advice for general practitioners and radiologists and will expose topics for further research.