Analyzing inappropriate magnetic resonance imaging (MRI) prescriptions and resulting economic burden on patients suffering from back pain

Jahanmehr, Nader; Bigdeli, Atieh Sadat; Salari, Hedayat; Mokarami, Hussein; Khodakarim, Soheila; Damiri, Soheila

doi:10.1002/hpm.2806

Cited by 14 publications

(14 citation statements)

References 32 publications

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“…In a study by Ebrahimipour et al (18), out of 115 knee MRI prescriptions, 63 (54.800 %) were incorrect. Several studies in Iran have focused on prescriptions without indication (19,20,21). Kavosi et al (19) reported that 21 percent of brain MRI prescriptions were inappropriate.…”

Section: Discussionmentioning

confidence: 99%

“…Kavosi et al (19) reported that 21 percent of brain MRI prescriptions were inappropriate. Jahanmehr et al (20) reported that 39.700 % of lumbar MRI was inappropriate. In a study conducted by Salari et al (21), 56 percent of lumbar spine prescriptions were incorrect.…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted by Salari et al (21), 56 percent of lumbar spine prescriptions were incorrect. In a descriptive, cross-sectional study by Sadeghi et al (20), the appropriateness of MRI services in Shahid Chamran Hospital in Shiraz was approximately 24 % (22). Therefore, it is clear that the number of unnecessary MRI prescriptions in Iran is high.…”

Section: Discussionmentioning

confidence: 99%

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Appropriateness of Brain Magnetic Resonance Imaging (MRI) Prescriptions and Imposed Financial Burden: Evidence from Iran

Kalantarhormozi¹,

Yazdanpanah²,

Yazdankhahfard³

et al. 2022

JEBHPME

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Background: The use of advanced and expensive technologies requires financial, human and capital resources. Brain Magnetic Resonance Imaging (MRI) has high contrast sensitivity for visualizing differences among the tissues. Unnecessary diagnostic imaging imposes excessive cost on health systems. This study aimed to determine the appropriateness of brain MRI prescriptions in 2021. Methods: This cross-sectional study recruited 274 patients who referred to Bushehr teaching hospital. They had been prescribed MRI of the brain due to headache and dizziness. We used the data collection form developed in the previous study. The appropriateness of the brain MRI prescription was determined based on the appropriate indications during 2021. Results: About 61 % of the referrals were due to headache and 39 % were because of dizziness. Overall, MRI was evaluated as inappropriate for about 38 % of the patients. The appropriateness of prescriptions had a significant relationship with age, gender, education, job status, complaint, prescribing physician, and MRI applicant with P-value < 0.050. Conclusion: Findings revealed more than one-third of brain MRI services were not clinically appropriate. Due to the high cost of MRI, it is necessary to make prescriptions in accordance with indications to prevent unnecessary diagnostic procedures and to prevent induced demand. Health system policymakers and healthcare providers should develop clinical guidelines and implement them to reduce the costs of health systems.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Appropriateness of Brain Magnetic Resonance Imaging (MRI) Prescriptions and Imposed Financial Burden: Evidence from Iran

Kalantarhormozi¹,

Yazdanpanah²,

Yazdankhahfard³

et al. 2022

JEBHPME

Self Cite

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“…5,6 With the increase in the number of requested MRI exams, it has been documented that between 10% and 50% of these exams are considered as unwarranted (or unnecessary) requests. 7 The majority of unnecessary MRIs are for lumbar spine 8 and knee pain complaints. 9 Many patients suffering from low back pain (LBP) or knee pain are routinely referred for MRI prior to having a specialist consultation.…”

Section: Introductionmentioning

confidence: 99%

“…9 Many patients suffering from low back pain (LBP) or knee pain are routinely referred for MRI prior to having a specialist consultation. 7 However, diagnostic imaging guidelines do not recommend MRI as a routine imaging procedure in these cases. 8 For patients with moderate to severe knee osteoarthritis (OA) and degenerative changes, evidence-based guidelines recommend a thorough clinical examination supplemented by weightbearing radiographs over a knee MRI scan in showing degenerative changes.…”

Section: Introductionmentioning

confidence: 99%

Exploring the impact of diagnostic imaging decision support embedded in an electronic referral solution on the appropriate ordering of magnetic resonance imaging for patients with knee pain: a retrospective chart review

Mohammed¹,

Payson

Gillan

et al. 2021

Evaluation Clinical Practice

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Rational and objective: Requests for magnetic resonance imaging (MRI) exams have notably increased in Canada. However, many of these exams may not always be indicated. The Joint Department of Medical Imaging and the eReferral Program have worked collaboratively to embed an integrated clinical decision support (DS) tool within the eReferral process for diagnostic imaging requests. This retrospective chart review aimed to assess the necessity of MRI exams for knee pain patients at the point of referral in relation to the referral method (no DS tools within fax-vs. DS tools within eReferral).Methods: Seven hundred and seventeen medical charts of routine MRI referral requests to an Ontario Hospital for patients with knee complaints were reviewed during the study period. The necessity of the MRI exams was evaluated using the supporting algorithm and knee pathway appropriateness guidelines. MRI exams were considered necessary if requested for symptoms or signs that align with best-practice standards, complemented with sound clinical assessment or history of a radiography scan before ordering an MRI.Results: In general, MRI requests made through eReferral were 13.289 times more likely to be necessary orders than those made through fax. The likelihood of referring patients for a necessary MRI exam was higher for eReferral than fax for the year 2018/2019 (53.0% vs. 26.8%, P < 0.001) and for the year 2019/2020 (58.5% vs. 16.3%, P < 0.001). In addition, the rate of ordering X-ray as the proper initial imaging scan for patients presenting with knee pain has steadily increased by 10% over the year for users of the eReferral platform compared to a decrease of 7% for those using fax.

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Cost of Low-Value Imaging Worldwide: A Systematic Review

Kjelle,

Brandsæter,

Andersen

et al. 2024

Appl Health Econ Health Policy

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Background and Objective Imaging with low or no benefit for the patient undermines the quality of care and amounts to vast opportunity costs. More than 3.6 billion imaging examinations are performed annually, and about 20–50% of these are of low value. This study aimed to synthesize knowledge of the costs of low-value imaging worldwide. Methods This systematic review was based on the PRISMA statement. The database search was developed in Medline and further adapted to Embase-Ovid, Cochrane Library, and Scopus. Primary empirical studies assessing the costs of low-value diagnostic imaging were included if published between 2012 and March 2022. Studies designed as randomized controlled trials, non-randomized trials, cohort studies, cross-sectional studies, descriptive studies, cost analysis, cost-effectiveness analysis, and mixed-methods studies were eligible. The analysis was descriptive. Results Of 5,567 records identified, 106 were included. Most of the studies included were conducted in the USA ( n = 76), and a hospital or medical center was the most common setting ( n = 82). Thirty-eight of the included studies calculated the costs of multiple imaging modalities; in studies with only one imaging modality included, conventional radiography was the most common ( n = 32). Aggregated costs for low-value examinations amounts to billions of dollars per year globally. Initiatives to reduce low-value imaging may reduce costs by up to 95% without harming patients. Conclusions This study is the first systematic review of the cost of low-value imaging worldwide, documenting a high potential for cost reduction. Given the universal challenges with resource allocation, the large amount used for low-value imaging represents a vast opportunity cost and offers great potential to improve the quality and efficiency of care. Supplementary Information The online version contains supplementary material available at 10.1007/s40258-024-00876-2.

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Analyzing inappropriate magnetic resonance imaging (MRI) prescriptions and resulting economic burden on patients suffering from back pain

Cited by 14 publications

References 32 publications

Appropriateness of Brain Magnetic Resonance Imaging (MRI) Prescriptions and Imposed Financial Burden: Evidence from Iran

Appropriateness of Brain Magnetic Resonance Imaging (MRI) Prescriptions and Imposed Financial Burden: Evidence from Iran

Exploring the impact of diagnostic imaging decision support embedded in an electronic referral solution on the appropriate ordering of magnetic resonance imaging for patients with knee pain: a retrospective chart review

Cost of Low-Value Imaging Worldwide: A Systematic Review

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