Providing Epidemiological Data in Lumbar Spine Imaging Reports Did Not Affect Subsequent Utilization of Spine Procedures: Secondary Outcomes from a Stepped-Wedge Randomized Controlled Trial
| Autor: | Zachary A. Marcum, Karen J. Sherman, Pradeep Suri, Judith A. Turner, Richard A. Deyo, David F. Kallmes, Janna L. Friedly, Brent Griffith, Jeffrey G. Jarvik, Patrick H. Luetmer, Laura S. Gold, Sean D. Rundell, Sandra K. Johnston, Brian W. Bresnahan, Kathryn T. James, Andrew L. Avins, Eric N. Meier, Patrick J. Heagerty, Michael K O'Reilly |
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| Rok vydání: | 2021 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty medicine.medical_treatment Lumbar vertebrae Zygapophyseal Joint Facet joint 03 medical and health sciences 0302 clinical medicine Lumbar medicine Humans 030212 general & internal medicine Interventional Pain & Spine Medicine Section Sacroiliac joint Lumbar Vertebrae business.industry Lumbosacral Region Facet joint injection General Medicine musculoskeletal system Low back pain United States Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Spinal fusion Spinal Diseases Neurology (clinical) medicine.symptom business Low Back Pain 030217 neurology & neurosurgery Lumbosacral joint |
| Zdroj: | Pain Med |
| ISSN: | 1526-4637 1526-2375 |
| DOI: | 10.1093/pm/pnab065 |
| Popis: | Objective To evaluate the effect of inserting epidemiological information into lumbar spine imaging reports on subsequent nonsurgical and surgical procedures involving the thoracolumbosacral spine and sacroiliac joints. Design Analysis of secondary outcomes from the Lumbar Imaging with Reporting of Epidemiology (LIRE) pragmatic stepped-wedge randomized trial. Setting Primary care clinics within four integrated health care systems in the United States. Subjects 238,886 patients ≥18 years of age who received lumbar diagnostic imaging between 2013 and 2016. Methods Clinics were randomized to receive text containing age- and modality-specific epidemiological benchmarks indicating the prevalence of common spine imaging findings in people without low back pain, inserted into lumbar spine imaging reports (the “LIRE intervention”). The study outcomes were receiving 1) any nonsurgical lumbosacral or sacroiliac spine procedure (lumbosacral epidural steroid injection, facet joint injection, or facet joint radiofrequency ablation; or sacroiliac joint injection) or 2) any surgical procedure involving the lumbar, sacral, or thoracic spine (decompression surgery or spinal fusion or other spine surgery). Results The LIRE intervention was not significantly associated with subsequent utilization of nonsurgical lumbosacral or sacroiliac spine procedures (odds ratio [OR] = 1.01, 95% confidence interval [CI] 0.93–1.09; P = 0.79) or any surgical procedure (OR = 0.99, 95 CI 0.91–1.07; P = 0.74) involving the lumbar, sacral, or thoracic spine. The intervention was also not significantly associated with any individual spine procedure. Conclusions Inserting epidemiological text into spine imaging reports had no effect on nonsurgical or surgical procedure utilization among patients receiving lumbar diagnostic imaging. |
| Databáze: | OpenAIRE |
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