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01-04-2020 | Magnetic Resonance Imaging of the Spine | Capsule Commentary

Capsule Commentary on Nevedal et al. “Factors Influencing Primary Care Providers’ Unneeded Lumbar Spine MRI Orders for Acute, Uncomplicated Low-Back Pain: a Qualitative Study Use of Patient Decision”

Author: Amir Mohammad Mohammad, MD, MPH, FACPM, FACOEM

Published in: Journal of General Internal Medicine | Issue 4/2020

Excerpt

In this qualitative study focusing on VA Primary Care Providers (PCPs), the authors highlight an expensive, recurring, and potentially harmful clinical practice. They interviewed PCPs and analyzed factors linked with increased ordering of lumbosacral (LS) MRI when evaluating low back pain among Veterans. They interviewed 55 high and low concordant back pain guideline PCPs, the majority based at satellite clinics, and found that while there were similar patient factors, there were significantly different provider level factors (guideline familiarity and agreement, the extent to which they acquiesced to patients, and belief in the value of LS MRI).¹ This study serves as a reminder that many factors contribute to decision-making and must be considered to avoid unnecessary and expensive imaging. …

Nevedal et. Factors Influencing Primary Care Providers’ Unneeded Lumbar Spine MRI Orders for Acute, Uncomplicated Low-back Pain: A Qualitative Study Use of patient decision. J Gen Intern med. 2019. [SPI 5410]

Chou R, Qaseem A, Owens DK, Shekelle P. Diagnostic imaging for low back pain: Advice for high-value health care from the American College of Physicians. Ann Intern Med 2011;154(3):181–189CrossRef

Chen D, Bhambhvani HP, Hom J, Mahoney M, Wintermark M, Sharp C, Ratliff J, Chen YR. Effect of Electronic Clinical Decision Support on Imaging for the Evaluation of Acute Low Back Pain in the Ambulatory Care Setting. World Neurosurg. 2019 . S1878–8750(19)32867–0. doi: https://doi.org/10.1016/j.wneu.2019.11.031 CrossRef

Doyle J, Abraham S, Feeney, L, Reimer, Finkelstein A. Clinical decision support for high-cost imaging: A randomized clinical trial. PLoS One. 2019 14(3):e0213373. doi: https://doi.org/10.1371/journal.pone.0213373. eCollection 2019.CrossRefPubMedPubMedCentral

Ganguli I, Simpkin, A, Lupo C, et al. Cascades of Care After Incidental Findings in a US National Survey of Physicians. JAMA Netw Open. 2019 2(10):e1913325.CrossRef

Title: Capsule Commentary on Nevedal et al. “Factors Influencing Primary Care Providers’ Unneeded Lumbar Spine MRI Orders for Acute, Uncomplicated Low-Back Pain: a Qualitative Study Use of Patient Decision”
Author: Amir Mohammad Mohammad, MD, MPH, FACPM, FACOEM
Publication date: 01-04-2020
Publisher: Springer International Publishing
Keywords: Magnetic Resonance Imaging of the Spine
Back Pain
Back Pain
Back Pain
Published in: Journal of General Internal Medicine / Issue 4/2020
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-020-05656-x

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Capsule Commentary on Nevedal et al. “Factors Influencing Primary Care Providers’ Unneeded Lumbar Spine MRI Orders for Acute, Uncomplicated Low-Back Pain: a Qualitative Study Use of Patient Decision”

Excerpt

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