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Related Experiment Videos

Reducing roentgenography use. Can patient expectations be altered?

R A Deyo, A K Diehl, M Rosenthal

    Archives of Internal Medicine
    |January 1, 1987
    PubMed
    Summary

    Delaying lumbar spine roentgenograms for back pain patients, using education instead, reduced costs and expectations of x-rays without missing diagnoses. This approach is safe and effective.

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    Area of Science:

    • Radiology
    • Health Economics
    • Patient Psychology

    Background:

    • Lumbar spine roentgenograms are frequently overutilized in managing back pain.
    • The psychological, functional, and financial impacts of routine imaging are not fully understood.

    Purpose of the Study:

    • To evaluate the consequences of omitting immediate spine films for patients with low-risk back pain.
    • To compare outcomes between immediate roentgenography and an educational intervention with delayed imaging.

    Main Methods:

    • Randomized controlled trial with two groups: immediate roentgenography (n=49) and education with delayed imaging (n=52).
    • Outcomes assessed included patient beliefs, functional status, symptom resolution, satisfaction, and healthcare costs.

    Main Results:

    • Fewer patients in the education group expected immediate x-rays (44% vs 73%).
    • Despite some delayed imaging, the education group incurred significantly lower radiology charges.
    • No serious diagnoses were missed, and symptom resolution, function, and satisfaction were comparable between groups.

    Conclusions:

    • Eliminating or delaying lumbar spine roentgenograms is safe and does not negatively impact patient outcomes or satisfaction.
    • This strategy can reduce healthcare costs and potentially alter future expectations regarding imaging use for back pain.

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