Towards appropriate imaging: Tips for practice.

BACKGROUND: The best use of diagnostic imaging is a challenge for many health professionals and the health system. Potential hazards of inappropriate imaging include exposure to ionising radiation, false positive and negative results, unexpected incidental findings, overdiagnosis and cost. OBJECTIVE: Using a fictional case, we aim to illuminate and discuss some of the challenges to appropriate diagnostic imaging and offer some solutions. DISCUSSION: While normal imaging results can reassure a patient, abnormal incidental findings can sometimes cause harm. When serious disease is very unlikely, verbal reassurance may be more appropriate than imaging. We remind doctors of the risks of ionising radiation, including how to access resources to estimate these risks and the need to ensure that the potential benefit of the test outweighs the risk - the process of justification. We point readers to imaging guidelines to help guide decision-making, such as the 'Diagnostic imaging pathways' resource. We look forward to relationships between radiologists and general practitioners characterised by collaboration and consultation, rather than just ordering and reporting.

EBM journal clubs in general practice.

The context of general practice makes the translation of evidence into clinical practice difficult. General practitioners interested in implementing evidence met at The Royal Australian College of General Practitioners' 2006 Annual Scientific Convention. We discussed evidence based medicine (EBM) journal club as a solution to this problem, including keys to success and barriers to overcome. The aim of this article is to provide suggestions for those wishing to set up their own EBM journal club. This will be supported as a Category 1 CPD activity by The Royal Australian College of General Practitioners in the 2008-2010 triennium.