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Abstract：
In Australia, general practitioners usually are the first point of contact for patients with non-urgent medical conditions. Appropriate and efficient utilisation of pathology tests by general practitioners forms a key part of diagnosis and monitoring. However overutilisationand underutilisation of pathology tests have been reported across several tests and conditions, despite evidence-based guidelines outlining best practice in pathology testing. There are a limited number of studies evaluating the impact of these guidelines on pathology testing in general practice. The aim of our quantitative observational study is to define how pathology tests are used in general practice and investigate how test ordering practices align with evidence-based pathology guidelines.
Access to non-identifiable patient data will be obtained through electronic health records from general practices across three primary health networks in Victoria, Australia. Numbers and characteristics of patients, general practices, encounters, pathology tests and problems managed over time will be described. Overall rates of encounters and tests, alongside more detailed investigation between subcategories (encounter year, patient\'s age, gender, and location and general practice size), will also be undertaken. To evaluate how general practitioner test ordering coincides with evidence-based guidelines, five key candidate indicators will be investigated: full blood counts for patients on clozapine medication; international normalised ratio measurements for patients on warfarin medication; glycated haemoglobin testing for monitoring patients with diabetes; vitamin D testing; and thyroid function testing.
Ethics clearance to collect data from general practice facilities has been obtained by the data provider from the RACGP National Research and Evaluation Ethics Committee (NREEC 17-008). Approval for the research group to use these data has been obtained from Macquarie University (5201700872). This study is funded by the Australian Government Department of Health Quality Use of Pathology Program (Agreement ID: 4-2QFVW4M). Findings will be reported to the Department of Health and disseminated in peer-reviewed academic journals and presentations (national and international conferences, industry forums).
Access to non-identifiable patient data will be obtained through electronic health records from general practices across three primary health networks in Victoria, Australia. Numbers and characteristics of patients, general practices, encounters, pathology tests and problems managed over time will be described. Overall rates of encounters and tests, alongside more detailed investigation between subcategories (encounter year, patient\'s age, gender, and location and general practice size), will also be undertaken. To evaluate how general practitioner test ordering coincides with evidence-based guidelines, five key candidate indicators will be investigated: full blood counts for patients on clozapine medication; international normalised ratio measurements for patients on warfarin medication; glycated haemoglobin testing for monitoring patients with diabetes; vitamin D testing; and thyroid function testing.
Ethics clearance to collect data from general practice facilities has been obtained by the data provider from the RACGP National Research and Evaluation Ethics Committee (NREEC 17-008). Approval for the research group to use these data has been obtained from Macquarie University (5201700872). This study is funded by the Australian Government Department of Health Quality Use of Pathology Program (Agreement ID: 4-2QFVW4M). Findings will be reported to the Department of Health and disseminated in peer-reviewed academic journals and presentations (national and international conferences, industry forums).
摘要：
在澳大利亚,全科医生通常是非紧急医疗状况患者的第一联系点。全科医生对病理测试的适当和有效利用是诊断和监测的关键部分。然而，在一些测试和条件下，病理测试的过度利用和未充分利用已经报道，尽管循证指南概述了病理学检测的最佳实践。评估这些指南对一般实践中病理测试的影响的研究数量有限。我们的定量观察研究的目的是定义病理学测试如何在一般实践中使用，并研究测试排序实践如何与循证病理学指南保持一致。
将通过维多利亚州三个初级卫生网络的一般实践，通过电子健康记录获得不可识别的患者数据。澳大利亚。患者的数量和特征，一般做法，遭遇,将描述病理测试和随时间管理的问题。接触和测试的总体比率，除了更详细的子类别之间的调查(相遇年，病人的年龄，性别,以及位置和一般做法大小)，也将进行。为了评估全科医生测试顺序与循证指南的一致性，将调查5项关键候选指标:氯氮平用药患者的全血计数;华法林用药患者的国际标准化比值测量;用于监测糖尿病患者的糖化血红蛋白检测;维生素D检测;和甲状腺功能检测.
数据提供者已从RACGP国家研究和评估伦理委员会（NREEC17-008）获得了从普通实践机构收集数据的伦理许可。研究小组使用这些数据的批准已从麦格理大学获得(5201700872)。本研究由澳大利亚政府卫生质量使用病理学计划（协议ID：4-2QFVW4M）资助。调查结果将报告给卫生部，并在同行评审的学术期刊和演讲中传播(国家和国际会议，行业论坛)。
将通过维多利亚州三个初级卫生网络的一般实践，通过电子健康记录获得不可识别的患者数据。澳大利亚。患者的数量和特征，一般做法，遭遇,将描述病理测试和随时间管理的问题。接触和测试的总体比率，除了更详细的子类别之间的调查(相遇年，病人的年龄，性别,以及位置和一般做法大小)，也将进行。为了评估全科医生测试顺序与循证指南的一致性，将调查5项关键候选指标:氯氮平用药患者的全血计数;华法林用药患者的国际标准化比值测量;用于监测糖尿病患者的糖化血红蛋白检测;维生素D检测;和甲状腺功能检测.
数据提供者已从RACGP国家研究和评估伦理委员会（NREEC17-008）获得了从普通实践机构收集数据的伦理许可。研究小组使用这些数据的批准已从麦格理大学获得(5201700872)。本研究由澳大利亚政府卫生质量使用病理学计划（协议ID：4-2QFVW4M）资助。调查结果将报告给卫生部，并在同行评审的学术期刊和演讲中传播(国家和国际会议，行业论坛)。
