Guidelines for referral of patients for carotid duplex scanning were introduced stating that scans were only indicated for patients with hemispheric localising symptoms or asymptomatic bruits. A 19% reduction in referral rate was seen for new scans in a one year period. The number of “inappropriate” requests fell from 2 7.6% in 1994 to 12.8% in 1995. There was no reduction in the numbers of patients identified with effectively occult asymptomatic disease who may have been suitable for surgery in the same period. Guideline introduction had the effect of reducing unnecessary scans without any effect on the overall pick-up, rate for carotid disease.
Medical Research Council European Carotid Surgery Trial. Interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis. Lancet1991; 337: 1235–1243.
2.
HoldsworthRJ, McCollumPT, StonebridgePA, BryceJ, HarrisonDK. What are the indications for a carotid duplex scan?Clinical Radiology1996; 51: 801–803.
3.
Moselyl, StevensJ. What are the indications for a carotid duplex scan? (Letter). (Letter). Clinical Radiology1997; 52: 480–483.
4.
North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effects of carotid endarterectomy in symptomatic patients with high grade stenosis. New England Journal of Medicine1991; 325: 445–453.
