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Fig. 1 EPAREP established rheumatology patient referral algorithm at University Teaching Hospital (UTH), Lusaka, Zambia.
They were also referred to local health services and HIV support groups according to a referral algorithm that took into account their clinical condition and the available community services as well as locally accepted standards of care.
High-risk patients were examined by myocardial perfusion imaging (MPI) (n = 109), computed tomography angiography (n = 20), or CAG (n = 86), according to our study referral algorithm for patients with abnormal results of the noninvasive tests for further invasive examination (13).
Between 1 July 2010 and 30 June 2012, 225 consecutive patients with suspected or previously diagnosed CVD, including blood pressure and heart rate, were assessed at first visit to the joint cardiac obstetric clinic, having been sent there via a referral algorithm from primary care and secondary care facilities in Cape Town and from within the tertiary hospital (figure 1).
Using the referral algorithm described in Research Design and Methods, 25 of 121 children (20.6%) were referred for follow-up psychology services, of which 13 (52%) were white, six (24%) were African American, five (20%) were Latino, and one (4%) was Arabic, which closely approximates our cohort's demographics.
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Improved referral algorithms for children with non-severe pneumonia at the community level are desirable.
Three of the studies with doctors reported priority or referral algorithms.
The quality scoring of quantitative studies (excluding the three studies on referral algorithms) is presented in Table 1.
Predictors of greatest interest were those not currently utilized in referral algorithms and feasible to obtain at the community level.
Finally, the lack of prospective studies confirming clinical effectiveness of the referral algorithms after implementation has also previously been noted.
We placed the greatest emphasis on predictors not currently incorporated into referral algorithms and those that were also measureable by CHWs.
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