Objective: Even though gastrointestinal complaints are among the
most frequent reasons to contact general medical practioners, little is known
about the actual care of these patients, especially the use of diagnostic
imaging technologies.
Methods: In a network of 57 family practitioners and 29 general
internists in Lower Saxony, Germany, 1,217 contacts with patients with
gastrointestinal diseases (16%, gastritis; 12%, gastroenteritis; 6%,
cholelithiasis; 5% each, ulcus ventriculi and duodeni, and 14%, no final
diagnosis) were documented. The effects of patient and physician/practice
side factors on the use of ultrasonography and radiography were modeled using
multivariate logistic regression.
Results: For ultrasonography, diagnosis and ownership of an
ultrasound unit (odds ratio [OR] = 3.33) were highly significant
predictors (p < .0001), followed by unknown diagnosis at beginning
of contact (OR = 1.92; p = .0019), physician specialty (OR for
internists = 1.89; p = .0025), and severity (p = .0085). For
radiography, ownership of an ultrasound unit was the most significant factor
(OR = 0.34; p < .0001), followed by severity (p <
.0009), ownership of x-ray apparatus (OR = 2.56; p = .0025),
physician specialty (OR for internists = 1.98; p = .0358), and
unknown diagnosis at beginning of contact (OR = 1.79; p = .0451). Not
significant were age and sex of patient and diagnosis for radiography.
Conclusions: Physicians use diagnostic imaging technologies for
patients with gastrointestinal complaints according to severity and knowledge
about the diagnosis, but ownership of technology is the most predictive
factor.