Low-value imaging: concept analysis and definition

While there is an extensive literature on low-value imaging, there is no agreed definition of the concept. However, a clear and consistent definition of low-value imaging is crucial for providing comparable and targeted research, and for increasing the quality, safety, effectiveness, efficiency, and sustainability of imaging services. Accordingly, the purpose of this study is to provide a definition of low-value imaging.

Review and assessment of definitions of low-value care and of practical measures of low-value imaging in the literature combined with standard concept analysis to elaborate a definition of low-value imaging according to standard criteria for definitions, such as precision, non-circularity, applicability, (theoretical) justification, and distinctability. The applicability of the suggested definition is assessed by testing it on practical tasks and examples.

Based on a study of definitions of low value care and practical measures of low value imaging in the literature this study develops a definition of low-value imaging: Low value imaging is imaging that does not contribute to reducing the overall pain, dysfunction or suffering of the person that is examined (compared to alternative actions). Accordingly, low value imaging can result in more harm than benefit, may not change the clinical management of the patient, or not be cost-effective. The suggested definition satisfies general criteria for definition, is able to address practical tasks and examples of imaging, and can differentiate valuable from non-valuable imaging.

A clear and consistent definition of low-value imaging is provided and is crucial for improving the quality, safety, effectiveness, efficiency, and sustainability of medical imaging. The suggested definition can be used to differentiate between valuable and non-valuable imaging.