Table 2, Review protocol: GP access to radiology - Emergency and acute medical care in over 16s: service delivery and organisation

Review question	Does GP access to radiology and ultrasound with same day results improve outcomes?
Guideline condition and its definition	AME. Definition: people with suspected or confirmed acute medical emergencies.
Objectives	To determine if enhanced GP access to radiological and ultrasound investigations improves outcomes.
Review population	Adults and young people (16 years and over) presenting to a GP with a suspected or confirmed AME.
	Line of therapy not an inclusion criterion.
Interventions and comparators: generic/class; specific/drug (All interventions will be compared with each other, unless otherwise stated)	GP access to same day radiological (plain x-ray) and ultrasound (including Doppler) investigations with same day results at weekdays (out of hours) and weekends. GP access to same day radiological (plain x-ray) and ultrasound (including Doppler) investigations without same day results. Standard services- GP access to same day plain x-ray radiology during working hours (weekdays) with same day results.
Outcomes	- Mortality during the study period (Dichotomous) CRITICAL - Avoidable adverse events (including delay in diagnosis and treatment, misdiagnosis) during the study period (Dichotomous) CRITICAL - Quality of life during the study period (Continuous) CRITICAL - ED attendance during the study period (Dichotomous) CRITICAL - Admissions during the study period (Dichotomous) CRITICAL - Patient and/or carer satisfaction during the study period (Dichotomous) CRITICAL - Laboratory or Diagnostic turn around for result to GP during the study period (Dichotomous) (IMPORTANT)
Study design	Systematic reviews (SRs) of RCTs, RCTs, observational studies only to be included if no relevant SRs or RCTs are identified.
Unit of randomisation	Patient GP surgeries/practices.
Crossover study	Not permitted.
Minimum duration of study	Not defined.
Exclusions	None
Subgroup analyses if there is heterogeneity	- Frail elderly (Frail elderly; No frail elderly); Effects may be different in this group.
Search criteria	The databases to be searched are: Medline, Embase, the Cochrane Library Date limits for search: None Language: English only.

Review question

Does GP access to radiology and ultrasound with same day results improve outcomes?

Guideline condition and its definition

AME. Definition: people with suspected or confirmed acute medical emergencies.

Objectives

To determine if enhanced GP access to radiological and ultrasound investigations improves outcomes.

Review population

Adults and young people (16 years and over) presenting to a GP with a suspected or confirmed AME.

Line of therapy not an inclusion criterion.

Interventions and comparators: generic/class; specific/drug

(All interventions will be compared with each other, unless otherwise stated)

GP access to same day radiological (plain x-ray) and ultrasound (including Doppler) investigations with same day results at weekdays (out of hours) and weekends.

GP access to same day radiological (plain x-ray) and ultrasound (including Doppler) investigations without same day results.

Standard services- GP access to same day plain x-ray radiology during working hours (weekdays) with same day results.

Outcomes

-: Mortality during the study period (Dichotomous) CRITICAL
-: Avoidable adverse events (including delay in diagnosis and treatment, misdiagnosis) during the study period (Dichotomous) CRITICAL
-: Quality of life during the study period (Continuous) CRITICAL
-: ED attendance during the study period (Dichotomous) CRITICAL
-: Admissions during the study period (Dichotomous) CRITICAL
-: Patient and/or carer satisfaction during the study period (Dichotomous) CRITICAL
-: Laboratory or Diagnostic turn around for result to GP during the study period (Dichotomous) (IMPORTANT)

Study design

Systematic reviews (SRs) of RCTs, RCTs, observational studies only to be included if no relevant SRs or RCTs are identified.

Unit of randomisation

Patient

GP surgeries/practices.

Crossover study

Not permitted.

Minimum duration of study

Not defined.

Exclusions

None

Subgroup analyses if there is heterogeneity

-: Frail elderly (Frail elderly; No frail elderly); Effects may be different in this group.

Search criteria

The databases to be searched are: Medline, Embase, the Cochrane Library

Date limits for search: None

Language: English only.

From: Chapter 8, GP access to radiology

Emergency and acute medical care in over 16s: service delivery and organisation.

NICE Guideline, No. 94.

National Guideline Centre (UK).

London: National Institute for Health and Care Excellence (NICE); 2018 Mar.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Table 2Review protocol: GP access to radiology