Characteristics and Effectiveness of Interventions That Target the Reporting, Communication, or Clinical Interpretation of Lumbar Imaging Findings: A Systematic Review

Witherow, Jessica L; Jenkins, Hazel; Elliott, James M.; Ip, G H; Maher, Christopher G.; Magnussen, John; Hancock, Mark J.

doi:10.3174/ajnr.a7432

Cited by 2 publications

(3 citation statements)

References 34 publications

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“…Terms that are commonly provided in diagnostic imaging reports such as ‘disc degeneration’ are poorly understood by the general population [ 39 ], may increase patients perceived need for imaging [ 40 ], and may not, therefore, be inherently reassuring. Strategies have been investigated to try and reduce unintended harm associated with the reporting of radiographic findings [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Chiropractors’ perceptions on the use of spinal radiographs in clinical practice: a qualitative study

Searant,

Brown,

Jenkins

2024

Chiropr Man Therap

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Background Radiography is commonly used in the assessment of spinal disorders, despite a lack of high-quality evidence demonstrating improved clinical outcomes or additional benefit to the patient. There is disagreement amongst chiropractors regarding the appropriate use of radiography for clinical management. This study aims to qualitatively explore chiropractors’ perceptions on the use of spinal radiographs in clinical practice with respect to how they determine when to order radiographs; and how they use radiographs to inform clinical management. Methods Online qualitative semi-structured interviews were conducted with 17 Australian chiropractors who currently manage patients with spinal disorders. Convienence, snowball, and purposive sampling strategies were used to ensure an appropriate breadth and depth of participant characterisitcs and beliefs. Interview data were recorded, transcribed and analysed using framework analysis. Results Three themes were developed to describe how chiropractors determined when to order radiographs. These themes included specific findings from the clinical encounter that may inform clinical management, their perceptions of radiation risk, and the influence of clinical experience/intuition. Three themes and four subthemes were developed for how chiropractors use radiographs to inform their management. These themes explored the use of radiography for the application of chiropractic technique, as well as the role of radiographs in predicting patient prognosis, and as an educational tool to provide reassurance. Conclusion Australian chiropractors’ decision-making around spinal radiography is diverse and can be influenced by a number of clinical and external factors. Previously unexplored uses of spinal radiography in clinical practice were highlighted. Some chiropractors reported potential benefits of radiography that are currently not supported by research evidence. Future research should address how radiographic findings are reported to patients with spinal disorders and how this could be optimised to improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Chiropractors’ perceptions on the use of spinal radiographs in clinical practice: a qualitative study

Searant,

Brown,

Jenkins

2024

Chiropr Man Therap

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“…In an attempt to prevent harmful MSK image reporting behaviours, studies have evaluated the withholding of imaging reports,15 reassurance about the lack of serious pathology17 and the insertion of information about the prevalence of findings in the pain free population 18. A recent systematic review, however, found little evidence of effectiveness for any of the interventions 19. While these interventions attempted to change clinician-reporting behaviours, they did not outline a thorough intervention design process informed by theory.…”

Section: Introductionmentioning

confidence: 99%

“… 18 A recent systematic review, however, found little evidence of effectiveness for any of the interventions. 19 While these interventions attempted to change clinician-reporting behaviours, they did not outline a thorough intervention design process informed by theory. The National Institute for Health and Care Research and Medical Research Council 20 recommend using behavioural science in the development of interventions to improve effectiveness and the lack of such a process in these studies may have contributed to their lack of effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Characterising the interventions designed to affect the reporting of musculoskeletal imaging: a scoping review protocol using the COM-B model

Kirby,

MacMillan,

Liew

et al. 2023

BMJ Open

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IntroductionAttributing musculoskeletal (MSK) pain to normal and commonly occurring imaging findings, such as tendon, cartilage and spinal disc degeneration, has been shown to increase people’s fear of movement, reduce their optimism about recovery and increase healthcare costs. Interventions seeking to reduce the negative effects of MSK imaging reporting have had little effect. To understand the ineffectiveness of these interventions, this study seeks to scope their behavioural targets, intended mechanisms of action and theoretical underpinnings. This information alongside known barriers to helpful reporting can enable researchers to refine or create new more targeted interventions.Methods and analysisThe scoping review will be conducted in accordance with the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Search terms will be devised by the research team. Searches of MEDLINE, EMBASE, CINAHL, AMED and PsycINFO from inception to current day will be performed. The review will include studies, which have developed or evaluated interventions targeting the reporting of MSK imaging. Studies targeting the diagnosis of serious causes of MSK pain will be excluded. Two independent authors will extract study participant data using predefined extraction templates and intervention details using the Template for Intervention Description and Replication checklist. Interventions will be coded and mapped to the technique, mechanism of action and behavioural target according to the Capability, Opportunity, Motivation-Behaviour (COM-B) model categories. Any explicit models or theories used to inform the selection of interventions will be extracted and coded. The study characteristics, behaviour change techniques identified, behavioural targets according to the COM-B and context specific theories within the studies will be presented in narrative and table form.Ethics and disseminationThe information from this review will be used to inform an intervention design process seeking to improve the communication of imaging results. The results will also be disseminated through a peer-reviewed publication, conference presentations and stakeholder events.

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Characteristics and Effectiveness of Interventions That Target the Reporting, Communication, or Clinical Interpretation of Lumbar Imaging Findings: A Systematic Review

Cited by 2 publications

References 34 publications

Chiropractors’ perceptions on the use of spinal radiographs in clinical practice: a qualitative study

Chiropractors’ perceptions on the use of spinal radiographs in clinical practice: a qualitative study

Characterising the interventions designed to affect the reporting of musculoskeletal imaging: a scoping review protocol using the COM-B model

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