Diagnostic Imaging

Posted on Feb 8, 2011 in Clinical Updates | 0 comments

New Guideline Discourages Routine Use of Diagnostic Imaging for Low Back Pain

 

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According to a new clinical guideline from the American College of Physicians (ACP) published in the Annals of Internal Medicine, diagnostic imaging for low back pain increases complications and costs but does not improve clinical outcomes. Low back pain is one of the most common reasons for a patient to see a healthcare provider and many patients with low back pain receive routine imaging that is not beneficial and can lead to a series of unnecessary additional tests, interventions, follow-ups, and referrals.

The authors revisit the guidelines issued by the ACP and the American Pain Society in 2007 and add evidence from a meta-analysis of six clinical trials. Based on these data, ACP recommends that routine or advanced imaging studies should only be performed in selected higher-risk patients who have severe or progressive neurologic deficits, are suspected of having a serious or specific underlying condition, or are candidates for invasive interventions.

The new ACP guideline also states that

• Decisions for repeat imaging should be based on the development of new symptoms or changes in current symptoms.
• To be most effective, efforts to reduce routine imaging should take into account clinician behaviors, patient expectations, and financial incentives.
• Patient education strategies should be utilized to inform patients about current and effective standards of care and help them understand the benefits and harms of the radiological testing.

Published on February 8, 2011

Source: Chou R, Qaseem A, Owens DK, Shekelle P; for the Clinical Guidelines Committee of the American College of Physicians. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Int Med. 2011;154(3):181-189.