Routine referral for radiography of patients presenting with low back pain: is patients' outcome influenced by GPs' referral for plain radiography?

Abstract

Rink E, Lord J. Routine referral for radiography of patients presenting with low back pain: is patients' outcome influenced by GPs' referral for plain radiography ? Health Technol Assess 2000;4(20).Health Technology Assessment is indexed in Index Medicus/MEDLINE and Excerpta Medica/ EMBASE. Copies of the Executive Summaries are available from the NCCHTA website (see overleaf). NHS R&D HTA ProgrammeT he overall aim of the NHS R&D Health Technology Assessment (HTA) programme is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and work in the NHS. Research is undertaken in those areas where the evidence will lead to the greatest benefits to patients, either through improved patient outcomes or the most efficient use of NHS resources.The Standing Group on Health Technology advises on national priorities for health technology assessment. Six advisory panels assist the Standing Group in identifying and prioritising projects. These priorities are then considered by the HTA Commissioning Board supported by the National Coordinating Centre for HTA (NCCHTA).This report is one of a series covering acute care, diagnostics and imaging, methodology, pharmaceuticals, population screening, and primary and community care. It was identified as a priority by the Diagnostics and Imaging Panel and funded as project number 93/17/11. The views expressed in this publication are those of the authors and not necessarily those of the Standing Group, the Commissioning Board, the Panel members or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for the recommendations for policy contained herein. In particular, policy options in the area of screening will be considered by the National Screening Committee. This Committee, chaired by the Chief Medical Officer, will take into account the views expressed here, further available evidence and other relevant considerations.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. Criteria for inclusion in the HTA monograph seriesReports are published in the HTA monograph series if (1) they have resulted from work either prioritised by the Standing Group on Health Technology, or otherwise commissioned for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors.

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

“…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]. Although the DAMASK trial had 6 publications [14,[39][40][41][42][43] only one [14] met the inclusion criteria.…”

Computed tomography–evaluated features of spinal degeneration: prevalence, intercorrelation, and association with self-reported low back pain

“…In primary care settings, the most common spine imaging tests for assessing LBP are plain radiography, computed tomography (CT), magnetic resonance imaging (MRI), and bone scanning. Low cost and ready availability make plain radiography the most common of these [8,9]. However, a systematic review of published observational studies found no strong evidence supporting the presence of a causal relationship between radiographic findings and nonspecific LBP [10].…”

INVESTIGATE-I (INVasive Evaluation before Surgical Treatment of Incontinence Gives Added Therapeutic Effect?): study protocol for a mixed methods study to assess the feasibility of a future randomised controlled trial of the clinical utility of invasive urodynamic testing

“…Trials reported in 2000 and 2001 randomizing radiography investigations for low back pain were only able to recruit 23% and 51% of patients approached to enter the randomised arms [15,16]. By assessing patients' willingness to undergo randomisation, potential barriers and facilitators to participation can be identified and used to modify the design of the definitive trial.…”