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Effectiveness of Interventions to Decrease Image Ordering for Low Back Pain Presentations in the Emergency

Chaocheng Liu1, Shashwat Desai1, Lynette D Krebs1

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Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
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PubMed
Summary
This summary is machine-generated.

Interventions can reduce simple imaging for low back pain (LBP) in the emergency department (ED), but may shift advanced imaging use. More research is needed to optimize these strategies.

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Area of Science:

  • Emergency Medicine
  • Radiology
  • Health Services Research

Background:

  • Low back pain (LBP) is a common emergency department (ED) presentation.
  • Imaging for LBP in the ED is frequent despite limited evidence of utility.
  • Overuse of advanced imaging like CT and MRI for LBP is a growing concern.

Purpose of the Study:

  • To review interventions reducing imaging for LBP patients in the ED.
  • To assess the effectiveness of these interventions in decreasing image ordering.

Main Methods:

  • Systematic review following PRISMA guidelines.
  • Searched six databases and gray literature for comparative studies.
  • Included studies focused on interventions targeting image ordering for adult LBP patients in the ED.

Main Results:

  • Five before-after studies were included, with potential biases noted.
  • Interventions included decision support tools, guidelines, and protocols.
  • Four studies showed decreased imaging (22.7%-47.4%), but one showed increased referrals for simple radiography and another for CT/myelography.

Conclusions:

  • Evidence for interventions reducing ED LBP imaging is sparse.
  • Simple imaging may decrease, but advanced imaging use might shift.
  • Higher-quality studies are recommended to evaluate ED-based interventions for LBP imaging reduction.