No abstract

More years of experience as a general practitioner and a shorter duration of consultations correlated with a better response to advice given in the feedback.

Feedback to general practitioners about the diagnostic tests they request reduces the number of requests.' This effect disappears, however, soon after feedback is stopped.2 Most studies have been short, so data on the long term effects offeedback are lacking.3The Diagnostic Coordinating Centre Maastricht has provided feedback continuously since 1985, resulting in a more rational use of tests and fewer requests.45 We report the effects of nine years of feedback. We also investigated its effects on requests for tests that were not advised but had a recommended alternative. We expected the effects to be greatest for such requests. We thought that if general practitioners had a choice of alternative tests they might be more willing to follow recommendations. Methods and resultsThe Requests for tests increased each year in the Netherlands, but in our region they decreased after 1985. Requests for all tests were affected, probably because of a general learning effect arising from the feedback.Although we could not determine patient outcome, we would not expect it to be adversely affected. In the feedback information we recommend the use of tests for specific indications or appropriate tests with high validity. The general practitioners changed their practices accordingly, so negative effects on patient outcome seem unlikely.Obviously, the smaller number of requests reduced the costs of diagnostic testing in the Maastricht region.