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29-09-2022 | Magnetic Resonance Imaging | Concise Research Report

Cascade Services and Spending Following Low-Value Imaging for Uncomplicated Low Back Pain among Commercially Insured Adults

Authors: Ishani Ganguli, MD, MPH, Wei Ying, MS, MBA, Tara Shakley, MS, James A. Colbert, MD, Kathleen L. Mulligan, BA, Mark W. Friedberg, MD, MPP

Published in: Journal of General Internal Medicine | Issue 4/2023

Excerpt

Previous studies have shown that low-value imaging for uncomplicated acute low back pain may trigger cascades of spine-related medical services with uncertain value and potential for harm¹ among injured workers,² veterans,³ and Medicare Advantage members.⁴ Building on this work, we examined cascades fully (e.g., including incidental extra-spinal findings) to estimate both total and out-of-pocket spending on cascades following low-value X-rays and magnetic resonance imaging (MRI) for uncomplicated acute low back pain among commercially-insured adults. …

Ganguli I, Simpkin AL, Lupo C, et al. Cascades of care after incidental findings in a US National Survey Of Physicians. JAMA Netw Open. 2019;2(10):e1913325. https://doi.org/10.1001/jamanetworkopen.2019.13325.

Webster BS, Choi Y, Bauer AZ, Cifuentes M, Pransky G. The Cascade of medical services and associated longitudinal costs due to nonadherent magnetic resonance imaging for low back pain. Spine (Phila Pa 1976). 2014;39(17):1433-1440.

Jacobs JC, Jarvik JG, Chou R, et al. Observational study of the downstream consequences of inappropriate MRI of the lumbar spine. J Gen Intern Med. 2020;35(12):3605-3612. https://doi.org/10.1007/s11606-020-06181-7.

Comino EJ, Davies GP, Krastev Y, et al. A systematic review of interventions to enhance access to best practice primary health care for chronic disease management, prevention and episodic care. BMC Health Serv Res. 2012;12(1):415. https://doi.org/10.1186/1472-6963-12-415.

Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. Am J Neuroradiol. 2015;36(4):811-816. https://doi.org/10.3174/ajnr.A4173.

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):181-189. https://doi.org/10.7326/0003-4819-154-3-201102010-00008.

Title: Cascade Services and Spending Following Low-Value Imaging for Uncomplicated Low Back Pain among Commercially Insured Adults
Authors: Ishani Ganguli, MD, MPH
Wei Ying, MS, MBA
Tara Shakley, MS
James A. Colbert, MD
Kathleen L. Mulligan, BA
Mark W. Friedberg, MD, MPP
Publication date: 29-09-2022
Publisher: Springer International Publishing
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Back Pain
Back Pain
Back Pain
Published in: Journal of General Internal Medicine / Issue 4/2023
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-022-07829-2

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