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Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review.

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Low-value diagnostic imaging is common, contributing to healthcare waste. This study identified 84 types of low-value imaging, highlighting the need for reduced utilization in patient care.

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Area of Science:

  • Radiology
  • Health Services Research
  • Medical Economics

Background:

  • Inappropriate and wasteful use of healthcare resources is a significant global issue, accounting for 10-34% of health services spending.
  • Low-value diagnostic imaging, providing minimal clinical benefit, is a major contributor to this waste.
  • There is a critical knowledge gap regarding the types and prevalence of low-value imaging.

Purpose of the Study:

  • To identify and characterize low-value diagnostic imaging examinations in both adult and pediatric populations.
  • To quantify the extent of low-value imaging utilization across various clinical scenarios.
  • To provide a comprehensive overview to inform future interventions.

Main Methods:

  • A comprehensive scoping review of the published literature was conducted.
  • Searches were performed in Medline-Ovid, Embase-Ovid, Scopus, and Cochrane Library from 2010 to September 2020.
  • Inclusion criteria encompassed specific medical subject headings related to diagnostic imaging misuse and utilization.

Main Results:

  • A total of 370 studies were synthesized, identifying 84 distinct low-value imaging examinations.
  • Commonly identified low-value imaging included examinations for atraumatic pain, minor head injuries, trauma, and cancer staging.
  • The proportion of inappropriate or unnecessary imaging varied widely, ranging from 2% to 100%.

Conclusions:

  • A comprehensive list of low-value radiological examinations for adults and children has been compiled.
  • Further research is essential to understand the underlying reasons for low-value imaging utilization.
  • Developing and implementing interventions to reduce low-value imaging is crucial for international healthcare systems.