Effectiveness of interventions designed to reduce the use of imaging for low-back pain: a systematic review

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
Hazel J JenkinsJohn S Magnussen

Abstract

Rates of imaging for low-back pain are high and are associated with increased health care costs and radiation exposure as well as potentially poorer patient outcomes. We conducted a systematic review to investigate the effectiveness of interventions aimed at reducing the use of imaging for low-back pain. We searched MEDLINE, Embase, CINAHL and the Cochrane Central Register of Controlled Trials from the earliest records to June 23, 2014. We included randomized controlled trials, controlled clinical trials and interrupted time series studies that assessed interventions designed to reduce the use of imaging in any clinical setting, including primary, emergency and specialist care. Two independent reviewers extracted data and assessed risk of bias. We used raw data on imaging rates to calculate summary statistics. Study heterogeneity prevented meta-analysis. A total of 8500 records were identified through the literature search. Of the 54 potentially eligible studies reviewed in full, 7 were included in our review. Clinical decision support involving a modified referral form in a hospital setting reduced imaging by 36.8% (95% confidence interval [CI] 33.2% to 40.5%). Targeted reminders to primary care physicians of appropriate indic...Continue Reading

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Citations

Apr 16, 2016·Applied Clinical Informatics·Nicholas GenesUla Hwang
Aug 19, 2015·European Journal of Pain : EJP·H J JenkinsJ S Magnussen
Aug 9, 2015·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Islam Y ElgendyDavid E Winchester
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Jan 1, 2020·BMC Health Services Research·Anna Sofia SimulaJaro Karppinen
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Jan 29, 2019·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Stephen FlahertyGary J Young
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May 13, 2020·BMC Health Services Research·Ann Mari GransjøenBjørn Morten Hofmann
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Oct 9, 2021·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Sweekriti SharmaChris G Maher
Jul 19, 2017·Musculoskeletal Science & Practice·Arianne P Verhagen

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