Abstract
PURPOSE: To assess the impact of cross-sectional imaging with magnetic resonance (MR) imaging or computed tomography (CT) on clinical decision making for patients with lower back pain (LBP).
MATERIALS AND METHODS: A randomized controlled before-and-after study was performed in 145 patients who had symptomatic lumbar spinal disorders and had been referred to orthopedists or neurosurgeons. Participants were a subgroup within a multicenter pragmatic randomized comparison of two imaging policies on LBP treatment: "imaging" versus "no imaging," unless a clear indication developed. Paired assessments were made of diagnosis, diagnostic confidence, proposed treatment, treatment confidence at trial entry acid follow-up, and expectations of imaging. Data were analyzed according to the groups as randomized.
RESULTS: At follow-up, there were no statistically significant differences between the groups with respect to diagnosis or treatment plans. Significant increases in diagnostic and therapeutic confidence between trial entry and follow-up were observed for both groups, with a significantly greater increase in diagnostic confidence (P = .01) in the imaging group.
CONCLUSION: Imaging may increase diagnostic confidence but has minimal influence on diagnostic or therapeutic decisions for patients with LBP. The results highlight the need for evidence-based guidelines for imaging in LBP treatment.
Original language | English |
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Pages (from-to) | 393-399 |
Number of pages | 6 |
Journal | Radiology |
Volume | 220 |
Issue number | 2 |
Publication status | Published - 2001 |
Keywords
- efficacy study
- spine, abnormalities
- technology assessment
- THERAPEUTIC IMPACT
- EFFICACY
- DIAGNOSIS
- INTENTION
- QUALITY
- TRIALS
- SPINE