MRI of the Knee and Shoulder Performed Before Radiography

George, Elizabeth; Tsipas, Stavros; Wozniak, Gregory; Rubin, David A.; Seidenwurm, David; Raghavan, Kesav; Golden, William E.; Tallant, Colleen; Bhargavan-Chatfield, Mythreyi; Burleson, Judy; Rybicki, Frank J.

doi:10.1016/j.jacr.2014.05.014

Cited by 17 publications

(18 citation statements)

References 28 publications

(30 reference statements)

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“…We did not include MRI-based features as potential predictors in our models because the frontline standard-of-care diagnostic recommendations from several key professional societies and organizations is radiography for adult persons with knee complaints not associated with substantial trauma for which OA was a diagnostic possibility 24-26 .…”

Section: Methodsmentioning

confidence: 99%

The incident tibiofemoral osteoarthritis with rapid progression phenotype: development and validation of a prognostic prediction rule

Riddle

Stratford

Perera

2016

Osteoarthritis and Cartilage

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Objectives No clinical prediction rules were found for estimating the likelihood of developing incident radiographic tibiofemoral osteoarthritis with rapid progression. Such a tool would enhance prognostic capability for clinicians and researchers. Design We used two longitudinal datasets to independently derive (Multicenter Osteoarthritis Study) and validate (Osteoarthritis Initiative) a prognostic clinical prediction rule for estimating the probability of incident rapidly progressing radiographic knee OA in the following 4-5 years. Eligible subjects had at least one knee with a Kellgren and Lawrence (K&L) graded tibiofemoral joint of 0 or 1. Several potential risk factors were examined including obesity, age, knee alignment, frequent knee symptoms, contralateral knee osteoarthritis and knee injury history. Multiple logistic regression was used to identify significant predictors and area under the receiver operating characteristic curve (AUC) was used to assess discrimination. Results A total of 1,690 subjects participated in the derivation and 2,422 subjects participated in the validation of the clinical prediction rule. The multivariable model displayed good discrimination with AUC of 0.79 in the derivation dataset and 0.81 in the validation dataset. Conclusions Persons with contralateral knee OA, a baseline index knee OA grade of 1, higher BMI and higher baseline WOMAC Total scores were more likely to develop K&L grades of 3 or 4 within 5 years. Frequent knee symptoms at baseline was not a significant predictor. The prediction rule and nomogram can assist clinicians in estimating the probability of rapidly progressing radiographic knee OA and the nomogram can assist researchers conducting epidemiologic studies and clinical trials.

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Section: Methodsmentioning

confidence: 99%

The incident tibiofemoral osteoarthritis with rapid progression phenotype: development and validation of a prognostic prediction rule

Riddle

Stratford

Perera

2016

Osteoarthritis and Cartilage

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“…Nor did we examine if alternative modalities could have been an appropriate choice. Some studies have shown that less advanced imaging may prevent the need for exams [36],[37]. We also focused solely on the information provided on the requisition forms; in practice, radiologists may pursue additional sources of information to augment that provided on the forms.…”

Section: Discussionmentioning

confidence: 99%

A Day in the Life of MRI: The Variety and Appropriateness of Exams Being Performed in Canada

et al. 2018

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“…Reasons frequently cited for this issue include lack of education, awareness, and integration of AUC into medical school, residency, and fellowship training, and into professional practices of radiologists and nonradiologists. [35][36][37][38][39][40][41][42][43] Naming the ACR as a qualified entity to provide AUC under PAMA will potentially improve use of the ACR AC. Increased utilization of the ACR's (or any provider's) AUC will also hinge on the continued multidisciplinary collaboration in developing AC and the ability to present and support them on user-friendly platforms.…”

Section: Limitations Of Appropriate Use Criteriamentioning

confidence: 99%

“…Furthermore, the ACR AC will now be directly tied to CMS payments, financial incentives, and penalties. Although adherence to AUC appears to decrease the cost of health care, 35 effectiveness studies suggest that imaging modalities that have a lower appropriateness rating, such as ultrasound for evaluation of shoulder pathology, may have an equivalent impact on health outcomes compared with MRI, but at a lower cost. 45,46 This issue of addressing or excluding costs (and similarly, relative radiation doses) highlights one additional factor that can affect whether the intended audience will accept and use AUC and CDS or not: transparency of the organizations that construct the criteria.…”

Section: Limitations Of Appropriate Use Criteriamentioning

confidence: 99%

Appropriate Use Criteria in Musculoskeletal Imaging

Demertzis

Rubin

2017

Semin Musculoskelet Radiol

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In the United States, health care costs are spiraling upward at an unsustainable rate. Concurrently, medical specialties, legislatures, and the population each recognize the need to prove that current medical practices are effective, measured by outcomes. These forces necessitate a change in radiology's role, from emphasizing interpretation and reporting to maintaining and demonstrating quality and value. An important part of this task involves establishing the appropriateness of imaging tests by application of objective data and expert opinion in an effort to optimize resource utilization and modality selection. We explore the justifications for establishing appropriateness use criteria, various paradigms that have been applied to their creation, inherent limitations of appropriateness rules based on imperfect data, and challenges associated with their widespread implementation and utilization. An appendix of key terms that may be unfamiliar to radiologists is included for future reference.

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MRI of the Knee and Shoulder Performed Before Radiography

Cited by 17 publications

References 28 publications

The incident tibiofemoral osteoarthritis with rapid progression phenotype: development and validation of a prognostic prediction rule

The incident tibiofemoral osteoarthritis with rapid progression phenotype: development and validation of a prognostic prediction rule

A Day in the Life of MRI: The Variety and Appropriateness of Exams Being Performed in Canada

Appropriate Use Criteria in Musculoskeletal Imaging

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