| Autor: |
Trager, Robert, Anderson, Brian, Perez, Jaime, Casselberry, Regina, Dusek, Jeffery |
| Rok vydání: |
2022 |
| Předmět: |
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| DOI: |
10.17605/osf.io/t9myp |
| Popis: |
Background: Lumbar magnetic resonance imaging (MRI) is often overutilized in those with low back pain (LBP), associated with overtreatment, and does not improve health outcomes. This study will be the first to investigate the association between utilization of chiropractic spinal manipulative therapy (SMT) for radicular low back pain (LBP) and MRI utilization. We hypothesize that adults with incident radicular LBP receiving chiropractic SMT will have reduced odds of undergoing a lumbar MRI over a 6-week follow-up window as the primary outcome as well as at 6-months and 1-year, and findings will be maintained after controlling for key confounding variables. Methods: A national database of aggregated electronic health records (TriNetX) will be queried for adults age 20-70 with incident radicular LBP with a search window January 1, 2011 to one year preceding the search date. Patients with lumbar radiograph, computed tomography, MRI or a diagnosis warranting early appropriate MRI in the preceding 90 days will be excluded. Propensity score matching will be used to control for variables associated with lumbar MRI utilization. The odds of lumbar MRI at 6-week, 6-month, and 1-year follow-up windows following the index date of LBP diagnosis will be calculated. Results: Measures of association will include the number and percentage of patients undergoing lumbar MRI in each cohort and odds ratios with 95% confidence intervals and p-values for each follow-up window before and after propensity matching. Conclusions: This study will utilize a large propensity-matched sample to evaluate lumbar MRI utilization in recipients of chiropractic SMT relative to other forms of care. The results of this study will serve as a marker of MRI guideline concordance in the management of patients with radicular LBP. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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