Test ordering in an evidence free zone: Rates and associations of Australian general practice trainees' vitamin D test ordering.

Rationale, aims and objectives Indiscriminate health screening is increasingly seen as being problematic. In particular, vitamin D testing rates are increasing rapidly despite recommendations against population screening. The purpose of this study was to determine the level of vitamin D testing among family practice/general practitioner ( GP) trainees and to establish associations of this testing. Methods Cross-sectional analysis of data from the ReCEnT ( Registrars Clinical Encounters in Training) cohort study. The setting was GP practices in four Australian states. Data from 60 consecutive consultations per trainee were recorded each 6-month training term (up to four terms). Results Vitamin D tests were ordered in 726 (1.0%) of encounters ( n = 69 412). Vitamin D test ordering was significantly associated with patients being older, female and non- English speaking. Trainees were more likely to test if they worked in a completely bulk-billing practice (i.e. a practice without any patient payment), if more problems were dealt with, more pathology tests were ordered in the consultation and if a lipid profile was ordered. They were less likely to test if they sought in-consultation advice or information. The most common reasons for testing were 'check-up' and 'health maintenance'. Conclusions In this first report of associations of vitamin D testing in the GP setting, we found that non-targeted vitamin D testing (testing inconsistent with current guidelines) is widespread in GP trainees' practice. Adoption of more rational testing approaches is needed. [ABSTRACT FROM AUTHOR]