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The final referral score therefore represents how many of the information points in the template were actually articulated in the referral.
Conscientious GPs were therefore likely to score very high on the referral score, and this could bias the results in favour of the intervention.
With this model, the multi-level regression analysis suggested a significant intervention effect with an approximately 20%% higher referral score in the intervention group.
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Referral scores were divided into centiles, and a weighted Kappa analysis was performed using quadratic weights.
The referral scores varied widely for each diagnostic area (Fig. 2).
We found that referral scores and social support scores had less improvement over the course of the intervention.
The data also suggest that being a board certified GP improves the quality of written communication to specialist health services as measured by the referral scoring system.
Generalised estimating equations (GEE) were used to explore the relationship between speciality and referral scores by fitting a general linear model for the mean score that specified the within GP and within speciality correlation structure of the data.
Despite only five GPs completed the study, the large number of individual referrals combined with the six different specialities meant that this study had over 95% power at an alpha level of 0.05 to detect a mean difference in before and after referral scores of 26 points with the observed intra-cluster correlation of 0.41.
Of the 139 referrals scored 40% (55) were graded 5, 55% (76) scored 4, and 6% (8) scored 3. None of the referrals were considered inappropriate.
For similar reasons, the face validity of KPI 12 was questioned (percentage of OA referrals scored using the WCWL priority referral criteria).
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CEO of Professional Science Editing for Scientists @ prosciediting.com