Referral patterns for women with gynaecological symptoms: a national survey of gynaecologists

Ramanathan, S. A. and Baratiny, G. Y. and Stocks, N. P. and Searles, A. M. (2011) Referral patterns for women with gynaecological symptoms: a national survey of gynaecologists. In: 38th COSA Annual Scientific Meeting (COSA 2011), 15-17 Nov 2011, Perth, WA, Australia.

Abstract

Aim: To describe if and to whom gynaecologists refer women with symptoms attributable to endometrial, ovarian and vulval cancer and to identify patient and clinician factors predictive of referral.

Method: In a randomised incomplete block design, gynaecologists were presented with a randomised allocation of 12 vignettes, each containing a hypothetical scenario about a patient with gynaecological symptoms. Logistic
regression was used to estimate the odds of referrals being associated with study factors.

Results: Of the eligible 520 gynaecologists, 404 (77%) completed the vignettes online or returned their response by mail. Overall, 76% of endometrial vignettes, 75% of ovarian vignettes and 70% of vulval vignettes which had a high probability of cancer were referred; primarily to gynaecological oncologists (94%). For endometrial cancer, the two best predictors of referral were biopsy fi ndings of cancer (OR:13.8 95%CI 8.0–24.0) and the gender of the clinician (OR for female clinicians: 3.0 95%CI 1.8–5.2).
For ovarian cancer it was an elevated CA125 result (OR:12.2 95%CI 9.3–16.1) and ultrasound fi ndings of a solid cyst (OR:4.5 95%CI 3.6–5.7). For vulval cancer it was biopsy fi ndings of cancer (OR:232.0 95%CI 116.1–463.6) and presence of an ulcer (OR:2.0 95%CI 1.3–3.3). Private gynaecological
oncologist services could be accessed by 95% of metropolitan and 90% of rural gynaecologists; with 92% of these services associated with a cancer multidisciplinary team (MDT). Public gynaecological oncologist services
could be accessed by 94% of metropolitan and 97% of rural gynaecologists; with 97% associated with a MDT.

Conclusion: The results suggest variation in referral practices for women with gynaecological symptoms amongst gynaecologists and this variation does not appear to be associated with the presence or absence of Australian
evidence-based guidelines. There is a need for further research into understanding the basis of these differences including a review of the existing guidelines for ovarian cancer.


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Item Type: Conference or Workshop Item (Commonwealth Reporting Category E) (Poster)
Refereed: Yes
Item Status: Live Archive
Additional Information: Abstract only published - #231. Permanent restricted access , in accordance with the copyright policy of the publisher.
Faculty / Department / School: Current - Institute for Agriculture and the Environment
Date Deposited: 31 Aug 2016 03:24
Last Modified: 07 Jul 2017 02:20
Uncontrolled Keywords: gynaecologists; referrals; women's health; gynaecological symptoms
Fields of Research : 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111717 Primary Health Care
Socio-Economic Objective: C Society > 92 Health > 9205 Specific Population Health (excl. Indigenous Health) > 920506 Rural Health
Identification Number or DOI: 10.1111/j.1743-7563.2011.01472.x
URI: http://eprints.usq.edu.au/id/eprint/28621

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