期刊
PAIN MEDICINE
卷 22, 期 6, 页码 1272-1280出版社
OXFORD UNIV PRESS
DOI: 10.1093/pm/pnab065
关键词
Epidural Injections; Zygapophyseal Joint; Injection; Injections; Radiofrequency Ablation; Radiology; Spine; Lumbar
资金
- National Institutes of Health (NIH) Health Care Systems Research Collaboratory by the NIH Common Fund through the Office of Strategic Coordination within the Office of the NIH Director [U24AT009676]
- National Institutes of Health (NIH) Health Care Systems Research Collaboratory by the NIH Common Fund through National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) [UH2AT007766, UH3AR066795]
- UW Clinical Learning, Evidence and Research (CLEAR) Center for Musculoskeletal Disorders [NIH/NIAMS P30AR072572]
- VA Puget Sound Health Care System
The study found that inserting epidemiological information into lumbar spine imaging reports did not have a significant impact on subsequent nonsurgical and surgical procedure utilization involving the thoracolumbosacral spine and sacroiliac joints.
Objective. To evaluate the effect of inserting epidemiological information into lumbar spine imaging reports on subsequent nonsurgical and surgical procedures involving the thoracolumbosacral spine and sacroiliac joints. Design. Analysis of secondary outcomes from the Lumbar Imaging with Reporting of Epidemiology (LIRE) pragmatic stepped-wedge randomized trial. Setting. Primary care clinics within four integrated health care systems in the United States. Subjects. 238,886 patients >= 18 years of age who received lumbar diagnostic imaging between 2013 and 2016. Methods. Clinics were randomized to receive text containing age- and modality-specific epidemiological benchmarks indicating the prevalence of common spine imaging findings in people without low back pain, inserted into lumbar spine imaging reports (the LIRE intervention). The study outcomes were receiving 1) any nonsurgical lumbosacral or sacroiliac spine procedure (lumbosacral epidural steroid injection, facet joint injection, or facet joint radiofrequency ablation; or sacroiliac joint injection) or 2) any surgical procedure involving the lumbar, sacral, or thoracic spine (decompression surgery or spinal fusion or other spine surgery). Results. The LIRE intervention was not significantly associated with subsequent utilization of nonsurgical lumbosacral or sacroiliac spine procedures (odds ratio [OR] = 1.01, 95% confidence interval [CI] 0.93-1.09; P = 0.79) or any surgical procedure (OR = 0.99, 95 CI 0.91-1.07; P = 0.74) involving the lumbar, sacral, or thoracic spine. The intervention was also not significantly associated with any individual spine procedure. Conclusions. Inserting epidemiological text into spine imaging reports had no effect on nonsurgical or surgical procedure utilization among patients receiving lumbar diagnostic imaging.
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