Cost-Effectiveness of Lumbar Spine Radiography in Primary Care Patients With Low Back Pain

Abstract

Radiography is likely to be cost-effective only when satisfaction is valued relatively highly. Strategies to enhance satisfaction for patients with low back pain without using lumbar radiography should be pursued.

Effect of routine diagnostic imaging for patients with musculoskeletal disorders: A meta-analysis

“…After screening on title and abstract, 32 references remained. Then, screening the full-text article excluded 17 references, leaving 15 references for inclusion [11,[14][15][16][28][29][30][31][32][33][34][35][36][37][38]. Three RCTs were published twice [15,28,[35][36][37][38] and one trial had three different publications [11,33,34].…”

“…The study setting was either primary [14,28,29,32,33,35] or secondary health care [15,16,30,31]. Four trials specified the duration of complaints in their inclusion criteria; this ranged from ≤1 week to 12 weeks [11,16,28,31].…”

“…Imaging procedures may also lead to incidental findings, which can be found in both symptomatic and asymptomatic individuals [7,8] indicating that diagnostic imaging findings may not always be responsible for the complaints experienced by the patient. The USA has experienced a larger number of spine surgeries due to an increase in the rate of spinal imaging [9] and others have reported increasing costs due to diagnostic imaging [10][11][12]. On the other hand the advancements in medical imaging techniques like MRI and other high technological medical imaging techniques can be used to replace older imaging techniques.…”

Diagnostic Imaging Practice Guidelines for Musculoskeletal Complaints in Adults—An Evidence-Based Approach: Introduction

“…15 Such costs are unlikely to outweigh the effect of small reported increases in patient satisfaction, especially when considering potential risks of ionizing radiation exposure and lack of demonstrable benefits to patients. [16][17][18] It should be noted that this significant rise in expenditure has recently motivated the US Congress to reduce payments for such imaging services. 19 Several factors contributing to escalating imaging costs have been identified: the aging population; the practice of defensive medicine; overuse of diagnostic imaging; selfreferral abuses; duplicative studies; consumer demand; and advanced technology.…”

Imaging in rheumatology: degenarative diseases of the spine

“…Zu den Vorteilen gehören der geringe zeitliche Aufwand und die im Vergleich geringen Kosten [40]. Zu den Nachteilen zählt, dass das konventionelle Röntgenbild methodisch bedingt dem zugrunde liegenden pathologischen Prozess "zeitlich" nachhängt und vor allem frühe Veränderungen der Bandscheiben und angrenzenden Wirbelkörper nur unzureichend erfasst werden können.…”