Comparison of Knee MRIs Ordered by General Practitioners and Orthopedic Surgeons
Bibliographic record
Abstract
Background: Knee MRI is one of the most frequently ordered MRI examinations. Currently in our health region, access to ordering knee MRIs is limited to orthopedic surgeons, sports medicine physicians, and rheumatologists. However, general practitioners (GPs) can also order knee MRIs by seeking radiologistu2019s approval or by following up on radiologistu2019s recommendations on knee radiographs and/or ultrasound. The clinical impact of these scans ordered by GPs is uncertain, with a perception that they may be less likely to undergo surgical intervention.Purpose: To compare the surgical outcomes of patients that are referred for MRI by orthopedic surgeons versus GPs; and to further analyze the rate of surgical intervention of GPu2019s patients who attain knee MRIs due to various levels of radiologistsu2019 recommendations on prior imaging and direct conversation.Study Design: Cohort Study.Methods: Retrospective study of 363 patients referred by GPs (n=173), orthopedic surgeons (n=176), and sports medicine (n=14) for knee MRIs in Saskatoon during 2017. Radiologist recommendations for GP cases were grouped as u201cverbal discussionu201d of the case or by comment on previous imaging (follow-up of a u201cspecific structureu201d, follow-up of a u201cjoint effusionu201d, or general statement to get MRI u201cif concernedu201d). Chi-square testing and multivariable logistic regression were used to compare patients by surgical intervention status. Results: The intervention rate was higher for orthopedic referrals (26%). Overall intervention rate for GPs referrals was 19%, but by recommendation subgroup (verbal discussions or follow-up of specific findings) were 21% and 24% respectively. Mean patient age was higher in GP referrals (46 vs. 38), and older age was associated with less frequent surgery. The difference in overall group intervention rates resolved when age difference was taken into consideration.Conclusion: Surgical intervention following MRI is higher for patients referred by orthopedic surgeons, but some GP referred subgroups are similar. Lower intervention rates among GP patients appear partly attributable to older patient age.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.022 | 0.012 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.005 | 0.018 |
| Open science | 0.007 | 0.010 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.024 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".