ArticleBMJ open2019
Does changed referral options affect the use of MRI for patients with low back pain? Evidence from a natural experiment using nationwide data.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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
6 citing papers in PubMed.
- Reducing inappropriate lumbar MRI referrals: a Danish pre- and post-intervention study.Chiropractic & manual therapies · 2026Article
- Fracture trends in Denmark from 1997 to 2021.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Irish general practitioner (GP) perspectives on impact of direct access radiology on patient care in the community: results from a mixed-methods study.Irish journal of medical science · 2024Article
- The effect of clinical guidelines on the utilisation of radiographs in chiropractic clinics in Denmark - an interrupted time series analysis.Chiropractic & manual therapies · 2023Article
- The use of low-value imaging: the role of referral practice and access to imaging services in a representative area of Norway.Insights into imaging · 2023Article
- Categorisation of lumbar spine MRI referrals in Denmark as compliant or non-compliant to international imaging guidelines: an inter-rater reliability study.Chiropractic & manual therapies · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study reports lumbar MRI referral patterns in the Region of Southern Denmark (RSD) and investigates the hypothesis that we will see an increase in imaging rates (MRI rates) following new referral options to lumbar MRI in the RSD in comparison with the other regions in Denmark from 2010 to 2013.
designA difference-in-difference (DD) analysis, using general practitioners (GPs) in other regions as control, was used to test if the new referral options had an effect on the MRI rates.
settingIn 2010, RSD introduced organisational changes affecting the referral options for lumbar MRI. First, the possibility for direct referral to lumbar MRI was introduced GPs, and second, the region gathered all local spine departments into one specialist hospital called the Spine Centre.
participantsWe retrieved all lumbar MRIs performed on patients aged 18+ performed on Danish hospitals from 2008 to 2013 using the registries from Statistics Denmark. We use sociodemographic information from all Danish citizens aged 18+ aggregated to GP level. Primary and secondary outcome measures: lumbar MRI scans per 1000 capita enlisted with a GP (MRI rates) were calculated based on GPs patient list. Four referral types were made to describe changes in referral patterns.
resultsIn total 183 389 patients received 240 760 lumbar MRIs in the period. The use of the direct referral option by GPs in the RSD increased by 115% in the period from 2010 to 2013 and accounted for 34% of all referrals (n=6545) in 2013. MRI rates were significantly higher in RSD following the organisational changes (DD 1.389(0.925-1.852) lumbar MRI per 1.000 enlisted with a GP).
conclusionsIntroduction of organisational changes in RSD as direct referral to lumbar MRI from GPs and chiropractors as well as establishing a Spine Centre increase the lumbar MRI rate in comparison with other regions in Denmark.
Indexed as
Identifiers
What 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.