ArticleCanadian family physician Medecin de famille canadien2016
Imaging studies in patients with spinal pain: Practice audit evaluation of Choosing Wisely Canada recommendations.
Article in Canadian family physician Medecin de famille canadien, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Red flags for the early detection of spinal infection in back pain patients.BMC musculoskeletal disorders · 2019Pooled it
- An investigation into the chiropractic practice and communication of routine, repetitive radiographic imaging for the location of postural misalignments.Journal of clinical imaging science · 2024Review
- An investigation into the chiropractic practice and communication of routine repetitive radiographic imaging for the location of postural misalignments.Journal of clinical imaging science · 2024Review
- Examining Clinical Opinion and Experience Regarding Utilization of Plain Radiography of the Spine: Evidence from Surveying the Chiropractic Profession.Journal of clinical medicine · 2023Article
- Exploring emergency physicians' knowledge, attitudes, and behaviour towards Choosing Wisely in Taiwan.PloS one · 2022Article
- The association between guideline adherent radiographic imaging by chiropractic students and the diagnostic yield of clinically significant findings.The Journal of the Canadian Chiropractic Association · 2021Article
- Current evidence for spinal X-ray use in the chiropractic profession: a narrative review.Chiropractic & manual therapies · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate an a priori threshold for advanced imaging in patients with spinal pain.
designPatients with spinal pain in any region for 6 to 52 weeks were assessed to determine if radiologic studies beyond x-ray scans were indicated, including magnetic resonance imaging (MRI), computed tomography (CT), and radionuclide bone scans. An a priori threshold was set before MRI, CT, or bone scans would be considered. Those who did not have MRI, CT, or bone scans ordered were followed for at least 1 year to determine if any of them went on to be diagnosed with a more serious spinal disorder (eg, infection, fracture, spondylitis, tumour, neurologic compression).
settingFour large primary care clinics in Edmonton, Alta.
participantsA total of 1003 consecutively presenting patients with symptoms suspected to be related to the spine (for a duration of generally 6 to 52 weeks) who had not already undergone advanced imaging and did not have a diagnosis of nonbenign back pain.
main outcome measuresNumber of cases of nonbenign spinal disorder in participants who underwent advanced imaging and participants who did not undergo advanced imaging (ie, did not have any red flags).
resultsThere were 399 women (39.8%) and 604 men (60.2%). The mean (SD) age of the group was 47.2 (14.6) years. The mean (SD) duration of symptoms was 15.1 (8.6) weeks. Of the 1003 participants, 110 met an a priori threshold for undergoing at least 1 of MRI, CT, or bone scan. In these 110 participants, there were newly diagnosed cases of radiculopathy (n = 12), including a case of cauda equina syndrome; spondyloarthropathy (n = 6); occult fracture (n = 2); solitary metastasis (n = 1); epidural lipomatosis (n = 1); osteomyelitis (n = 1), and retroperitoneal hematoma (n = 1), each of which was considered likely to be the cause of the patient's spinal symptoms. The remaining 893 participants were followed for at least 1 year and none showed evidence of a nonbenign cause of his or her spinal pain.
conclusionIn the evaluation of nonspecific spinal pain and symptoms, setting and following an a priori threshold for ordering MRI, CT, or bone scans in the spirit of the current Choosing Wisely Canada recommendations has a very low risk of missing a case of a serious cause of back pain.
Indexed as
Identifiers
27427564PMC4984587W2310195257What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.