Implementing evidence-based guidelines for radiography in acute low back pain: A pilot study in a chiropractic community

Objective: To evaluate the ability of a systematic educational intervention strategy to change the plain radiography ordering behavior of chiropractors toward evidence-based practice for patients with acute low back pain (LBP). Design: A quasi-experimental method was used comparing outcomes before and after the intervention with those of a control community. Setting: Two communities in southern Ontario. Data Source: Mailed survey data on the management of acute LBP. Outcome Measures: Plain radiography use rates for acute LBP based on responses to mailed surveys. Results: Following the intervention, there was a 42% reduction in the self-report need for plain radiography for uncomplicated acute LBP (P < .025) and a 50% reduction for patients with acute LBP < 1 month (P < .025) in the intervention community. There was no significant change in the self-report need for plain radiography in the control community (P > .05). Conclusions: The educational intervention strategy used in this study appeared to have an effect in reducing the perceived need for plain radiography in acute LBP.