ArticleInternational journal of health policy and management2013
Evidence for Policy Making: Clinical Appropriateness Study of Lumbar Spine MRI Prescriptions Using RAND Appropriateness Method.
Article in International journal of health policy and management, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 30 citations in OpenAlex.
- Pertinence of magnetic resonance imaging in lumbar pain: a prospective surgeon-based evaluation of diagnostic concordance and therapeutic impact.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- "Diagnostic pathways in femoroacetabular impingement, patterns of clinical visits, and MRI utilization before hip arthroscopy in Türkiye".Scientific reports · 2025Article
- Challenges, barriers and solutions for implementing clinical practice guidelines: a qualitative study in southern Iran.BMJ open quality · 2024Article
- Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review.BMC medical imaging · 2022Article
- Agreement Between International Radiologists on the Appropriateness and Urgency in Lumbar Spine MRI Referrals.International journal of general medicine · 2022Article
- The inappropriateness of brain MRI prescriptions: a study from Iran.Cost effectiveness and resource allocation : C/E · 2021Article
- A Bayesian Network Decision Support Tool for Low Back Pain Using a RAND Appropriateness Procedure: Proposal and Internal Pilot Study.JMIR research protocols · 2021Article
- How radiological findings can help or hinder patients' recovery in the rehabilitation management of patients with low back pain: what can clinicians do?The Journal of manual & manipulative therapy · 2017Article
- Developing an Appropriateness Criteria for Knee MRI Using the Rand Appropriateness Method (RAM)-2013.The archives of bone and joint surgery · 2014Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMRI is a new and expensive diagnostic technology, which has been used increasingly all over the world. Low back pain is a worldwide prevalent disorder and MRI technique is one of the several ways to diagnose it. This paper aims to identify the appropriateness of lumbar spine MRI prescriptions in Shiraz teaching hospitals using standardized RAND Appropriateness Method (RAM) criteria in 2012.
methodsThis study consisted of two phases. The first phase involved a qualitative enquiry and the second phase had a quantitative cross-sectional nature. In the first phase RAM was used for developing lumbar spine MRI indications and scenarios. In the second phase, the finalized scenarios were compared with the history and physical examination of 300 patients with low back pain. The rate of appropriateness of lumbar spine MRI prescription was then calculated.
resultsOf 300 cases of lumbar spine MRI prescriptions, approximately 167 (56%) were considered inappropriate, 72 (24%) were uncertain, and 61 (20%) were deemed to be appropriate. The economic burden of inappropriate prescriptions was calculated at 88,009,000 Rials. In addition, the types of expertise and physical examination were considered as related factors to appropriateness of prescriptions.
conclusionIn conclusion, a large proportion of lumbar spine MRI prescriptions, which result in financial burden on the insurance companies and the patients alike is unnecessary. This study suggests that policy makers consider this evidence while decision-making. Our findings highlight the imperative role of Health Technology Assessment (HTA) and Clinical Practice Guidelines (CPGs). As a result, developing local clinical guidelines may create the commitment needed in physicians in prescribing appropriate prescriptions within the health sector. The study further recommends that appropriate scenarios should be considered as a criterion for payment and reimbursement.
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