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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 2/2016

01-02-2016 | Editorial

Can Parsimonious Practice Please Patients and Practitioners? The Case of Spine Imaging

Author: Richard A. Deyo, MD, MPH

Published in: Journal of General Internal Medicine | Issue 2/2016

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Excerpt

There now seems to be broad agreement that lumbar spine imaging is an overused clinical procedure. Clinical guidelines recommend against routine lumbar spine imaging for patients with nonspecific low back pain,1 and such imaging has become a high-priority target for the Choosing Wisely campaign. Nonetheless, spine imaging rates are generally higher than expected. Tan and colleagues now provide evidence that high use continues, and that there is wide variation among individual physicians in the use of imaging for older patients.2 …
Literature
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Brinjikji W, Luetmer PH, Comstock MS, Bresnahan BW, Chen LE, Deyo RA, Halabi S, Turner J, Avins AL, James K, Wald JT, Kallmes DF, Jarvik JG. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiol. 2015;36:811–816.PubMedCentralCrossRefPubMed
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Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet. 2009;373:463–472.CrossRefPubMed
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Jarvik JG, Hollingworth W, Martin B, et al. Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA. 2003;289:2810–8.CrossRefPubMed
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Kendrick D, Fielding K, Bentley E, Kerslake R, Miller P, Pringle M. Radiography of the lumbar spine in primary care patients with low back pain: randomised controlled trial. BMJ. 2001;322(7283):400–405.PubMedCentralCrossRefPubMed
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Webster BS, Choi YS, Bauer AZ, Cifuentes M, Pransky G. The cascade of medical services and associated longitudinal costs due to nonadherent magntic resonance imaging for low back pain. Spine. 2014;39:1433–40.PubMedCentralCrossRefPubMed
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Jarvik J, Gold LS, Comstock BA, Heagerty PJ, Rundell SD, Turner JA, Avins AL, Bauer Z, Bresnahan BW, Friedly JL, James K, Kessler, Nedeljkovic SS, Nerenz DR, Shi X, Sullivan SD, Chan L, Schwalb JM, Deyo RA. Association of early imaging for back pain with clinical outcomes in older adults. JAMA. 2015;313:1143–53.CrossRefPubMed
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Wilson IB, Dukes K, Greenfield S, Kaplan S, Hillman B. Patients’ role in the use of radiology testing for common office practice complaints. Arch Intern Med. 2001;161:256–263.CrossRefPubMed
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Pham HH, Landon BE, Reschovsky JD, Wu B, Schrag D. Rapidity and modality of imaging for acute low back pain in elderly patients. Arch Intern Med. 2009;169(10):972–981.PubMedCentralCrossRefPubMed
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Metadata
Title
Can Parsimonious Practice Please Patients and Practitioners? The Case of Spine Imaging
Author
Richard A. Deyo, MD, MPH
Publication date
01-02-2016
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 2/2016
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-015-3523-z

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