Research Reviewed: Observational Study of the Downstream Consequences of Inappropriate MRI of the Lumbar Spine (Jacobs et al, J Gen Intern Med; 9/28/20)
This week’s paper examined if ordering inappropriate lumbar (low back) MRIs - medical guidelines state that imaging of new episodes of uncomplicated non-specific low back pain is inappropriate within the first six weeks - leads to increased rates of surgery, prescription opioid use, acute health care costs, and pain within 1 year of the initial visit.
Methods
The researchers reviewed electronic health records of primary care clinics to find patients seeking primary care for non-specific low back pain without a red flag condition or an encounter for low back pain in the prior 6 months. The eventual sample size (N) equaled 405,965 (!).
Results
Early MRI in these cases was significantly associated with higher rates of back surgery, use of prescription opiods, higher final pain score, and higher acute costs (by nearly $2500).
Practical takeaways
This is a really important and landmark study due to the enormous sample size that adds significantly to the growing trend of research that shows early MRIs in low back pain leads to not only bloated costs but also negative impact on patient’s health.
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The downstream, hidden consequences of unnecessary low back (lumbar) MRI's
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Research Reviewed: Observational Study of the Downstream Consequences of Inappropriate MRI of the Lumbar Spine (Jacobs et al, J Gen Intern Med; 9/28/20)
This week’s paper examined if ordering inappropriate lumbar (low back) MRIs - medical guidelines state that imaging of new episodes of uncomplicated non-specific low back pain is inappropriate within the first six weeks - leads to increased rates of surgery, prescription opioid use, acute health care costs, and pain within 1 year of the initial visit.
Methods
The researchers reviewed electronic health records of primary care clinics to find patients seeking primary care for non-specific low back pain without a red flag condition or an encounter for low back pain in the prior 6 months. The eventual sample size (N) equaled 405,965 (!).
Results
Early MRI in these cases was significantly associated with higher rates of back surgery, use of prescription opiods, higher final pain score, and higher acute costs (by nearly $2500).
Practical takeaways
This is a really important and landmark study due to the enormous sample size that adds significantly to the growing trend of research that shows early MRIs in low back pain leads to not only bloated costs but also negative impact on patient’s health.