ACR Appropriateness Criteria® on Low Back Pain

Davis, Patricia C.; Wippold, Franz J.; Brunberg, James A.; Cornelius, Rebecca S.; Paz, Robert L. De La; Dormont, Pr Didier; Gray, Linda; Jordan, John E.; Mukherji, Suresh K.; Seidenwurm, David; Turski, Patrick A.; Zimmerman, Robert D.; Sloan, Michael A.

doi:10.1016/j.jacr.2009.02.008

Cited by 89 publications

(69 citation statements)

References 30 publications

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“…Most guidelines do not recommend radiographs for new-onset LBP. 31,32 However, practitioners report using imaging as a way to provide reassurance and enhance the provider-patient relationship. 33 This assumption has not been supported 34 , although patients report increased satisfaction when they receive imaging.…”

Section: Discussionmentioning

confidence: 99%

Relationship of Opioid Prescriptions to Physical Therapy Referral and Participation for Medicaid Patients with New-Onset Low Back Pain

et al. 2017

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Introduction: Physical therapy (PT) early in the management of low back pain (LBP) is associated with reductions in subsequent health care utilization and LBP-related costs. The objectives of this study were to 1) Examine differences among newly consulting patients with LBP who received a PT referral and those who did not, 2) examine differences between patients who participated in PT to those who did not, and 3) compare the impact of a PT referral and PT participation on LBP-related health care utilization and costs over 1 year.Methods: This was a retrospective cohort study using electronic medical records and claims data.

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Section: Discussionmentioning

confidence: 99%

Relationship of Opioid Prescriptions to Physical Therapy Referral and Participation for Medicaid Patients with New-Onset Low Back Pain

et al. 2017

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“…Additional imaging guideline resources are available from the American College of Radiology and include free online availability. 2,15 In summary, the guidelines provide a clear and succinct guide to appropriate imaging. As noted above, the use of imaging in the acute and subacute stages (up to 12 weeks) of an episode of LBP is only warranted as a method to rule out serious pathology and not one that should be employed to guide routine therapeutic decision making.…”

Section: Appropriate Use Ofmentioning

confidence: 99%

“…7 Though much less of a concern, gadolinium-based MR contrast agents carry some risk. 15 Generally, these agents remain very safe. However, it is recommended that gadolinium contrast agents should not be administered to patients with either acute or significant chronic kidney disease.…”

Section: Inappropriate Use Of Lumbar Spine Imaging: Harmful Effects Dmentioning

confidence: 99%

“…However, it is recommended that gadolinium contrast agents should not be administered to patients with either acute or significant chronic kidney disease. 15 Lumbar spine radiographs provide an estimated radiation dose equivalent to six months of background radiation (radiation associated with normal daily living). 48 While the risk is considered very low, it does incur a 1 in 100 000 to 1 in 10 000 risk of fatal cancer.…”

Section: Inappropriate Use Of Lumbar Spine Imaging: Harmful Effects Dmentioning

confidence: 99%

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Appropriate Use of Diagnostic Imaging in Low Back Pain: A Reminder That Unnecessary Imaging May Do as Much Harm as Good

Flynn

Smith²,

Chou³

2011

J Orthop Sports Phys Ther

127

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“…24 Given the chronicity of most back pain relative to other presenting neurologic symptoms, duration of symptoms and response to conservative treatment play an important role in imaging strategies, as detailed in a metaanalysis 25 and in multiple published guidelines (On-line Table 1). [26][27][28] Specifically, in the absence of "red flag" features, imaging…”

Section: Appropriate Neuroimaging Guidelinesmentioning

confidence: 99%

Neuroimaging Wisely

Buethe

Nazarian

Kalisz

et al. 2016

AJNR Am J Neuroradiol

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SUMMARY: Diagnostic imaging is the most rapidly growing physician service in the Medicare and privately insured population. The growing share of medical costs devoted to imaging procedures has led to increasing concerns among the key federal agencies and private payers. In an attempt to educate health care providers, patients, and families on the importance of making optimal clinical decisions, the American Board of Internal Medicine Foundation organized the Choosing Wisely initiative with strong collaboration from specialty societies representing nearly all medical disciplines. Among 45 tests and treatments listed on the Choosing Wisely Web site, 24 are directly related to imaging. Eleven of the 24 are associated with neuroimaging. The listing of imaging tests in the Choosing Wisely program by multiple medical societies other than the radiology societies acknowledges that appropriate use of medical imaging is a shared responsibility between radiologists and referring physicians. In this article, we highlight why radiologists are uniquely positioned to support the appropriate use of imaging. We review some of the strategies that radiologists can use to help their referring physicians with appropriate ordering of neuroimaging in real-world practice and address some the challenges and pitfalls in implementing patient-centered imaging decision-making and shifting to a value-based focus in radiology. ABBREVIATIONS: AAFP

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ACR Appropriateness Criteria® on Low Back Pain

Cited by 89 publications

References 30 publications

Relationship of Opioid Prescriptions to Physical Therapy Referral and Participation for Medicaid Patients with New-Onset Low Back Pain

Relationship of Opioid Prescriptions to Physical Therapy Referral and Participation for Medicaid Patients with New-Onset Low Back Pain

Appropriate Use of Diagnostic Imaging in Low Back Pain: A Reminder That Unnecessary Imaging May Do as Much Harm as Good

Neuroimaging Wisely

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