Have an account? Please log in.
Text size: Small font Default font Larger font
Radiology Daily
Radiology Daily PracticalReviews.com Radiology Daily

Canadian Study: Back Off MRI For Lower Back

  • Comments

The drumbeat for reducing MRI spine imaging has gotten louder this month. The latest: A research letter published online Monday in JAMA Internal Medicine reports on a study that found more than half of lower-back MRI scans ordered at two Canadian hospitals were either inappropriate (28.5 percent) or of uncertain value (27.2 percent).

On the other hand, the study approved of most head MRIs for headache patients at the hospitals.

The researchers used the RAND/UCLA Appropriateness Method, which combines best evidence and an expert panel. Of course, lots of doctors might like to have an expert panel available for consultation during actual patient visits rather than have such a panel second-guess them after the fact. Anyway, the researchers looked at lumbar spine MRIs ordered at the University of Alberta Hospital in Edmonton, Alberta, and The Ottawa Hospital in Ottawa, Ontario—500 at each hospital. They also examined the appropriateness of an equal number of head MRI scans for patients complaining of headache.

The researchers judged 82.8 percent of the head MRI scans appropriate. “The results tell us that we should not assume there is overuse in any given area without measuring,” said lead author Derek J. Emery, MD, a neuroradiologist at the University of Alberta. “We were surprised by the results about head MRIs. We thought the rate of inappropriate use would have been much higher, but the results showed otherwise.”

Dr. Emery was quoted in a university news release via EurekAlert! “MRI is a limited resource in Alberta,” he said, “so if the number of inappropriate MRIs can be reduced, there will be more capacity to perform MRIs on patients who really need them. This is all about improving patient care, imaging those patients who will benefit and not imaging those who will not.”

He added:

It is important to note that we did not measure underuse of MRIs. There are many patients who would benefit from MRIs who are not being imaged due to lack of access.

Earlier this month, a study published in the New England Journal of Medicine found that follow-up MRI on patients with lumbar-disk herniation and persistent symptoms of sciatica “did not distinguish between those with a favorable outcome and those with an unfavorable outcome.” An accompanying editorial labeled such imaging a “red herring”—an unnecessary test often requested by anxious patients “just to be sure.”

Dr. Emery’s conclusion: “I think we need to provide better tools to doctors to help them determine when imaging of the lower back is likely to help.”

Related seminar: New Horizons in Musculoskeletal MRI (all new release)


Permalink: http://www.radiologydaily.com/?p=10507


  • No Related Posts
  • Comments

Would you like to keep current with radiological news and information?

Post Your Comments and Responses

Comments are closed.