Compliance of General Practitioners with a Guideline-Based Decision Support System for Ordering Blood Tests (Evidence-Based Laboratory Medicine and Test Utilization‪)‬

Dutch investigators report that a lack of general practitioners' knowledge concerning the indications for blood tests leads to inappropriate use of diagnostic tests (1). Investigators argue that improving the quality of blood test ordering deserves attention (2, 3). To deal with the rapidly expanding body of medical knowledge, guidelines are increasingly viewed as a mechanism for distributing knowledge to practitioners (4, 5). In The Netherlands, the Dutch College of General Practitioners issues guidelines for the general practitioner. The procedure for creating a guideline consists of four stages (6). The first stage involves the selection of topics for new guidelines by an independent advisory board. In the second stage, a small taskforce, consisting of four to eight general practitioners with special interest in and expertise on the topic of that guideline, prepares a draft. This draft is based on a review of the available literature, current medical practice, and consensus in the taskforce with respect to appropriate medical practice in primary care. In the third stage, a random sample of general practitioners and specialists reviews this draft. The final stage involves authorization of the guideline by a board consisting of leading general practitioners. After authorization, the guideline is published in the journal of the Dutch College of General Practitioners. After publication, the guidelines are revised at regular intervals.