Evidence map›Paper›PMID 31785613›Full record

ArticleBMC musculoskeletal disorders2019

Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis.

Mujahed Shraim, Manuel Cifuentes, Joanna L Willetts, Helen R Marucci-Wellman, Glenn Pransky

Open access · goldAbstract read
In one paragraph

Article in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Magnetic Resonance Imaging in the Year Prior to Total Knee Arthroplasty: A Potential Overutilization of Healthcare Resources.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Mujahed ShraimDepartment of Public Health, College of Health Sciences, QU Health, Qatar University, P.O.Box: 2713, Doha, Qatar. mshraim@qu.edu.qa.
Manuel CifuentesRegis College, 235 Wellesley St, Weston, MA, USA.
Joanna L WillettsLiberty Mutual Research Institute for Safety, Hopkinton, MA, USA.
Helen R Marucci-WellmanLiberty Mutual Research Institute for Safety, Hopkinton, MA, USA.
Glenn PranskyUniversity of Massachusetts Medical School, 55 N Lake Ave, Worcester, MA, USA.
Liberty Mutual Research Institute for Safety · USQatar University · QARegis College · USUniversity of Massachusetts Chan Medical School · US

Funding

Liberty Mutual Research Institute for Safety Not applicable
6 · The paper itself

Abstract

backgroundEarly magnetic resonance imaging (eMRI) for nonspecific low back pain (LBP) not adherent to clinical guidelines is linked with prolonged work disability. Although the prevalence of eMRI for occupational LBP varies substantially among states, it is unknown whether the risk of prolonged disability associated with eMRI varies according to individual and area-level characteristics. The aim was to explore whether the known risk of increased length of disability (LOD) associated with eMRI scanning not adherent to guidelines for occupational LBP varies according to patient and area-level characteristics, and the potential reasons for any observed variations.

methodsA retrospective cohort of 59,360 LBP cases from 49 states, filed between 2002 and 2008, and examined LOD as the outcome. LBP cases with at least 1 day of work disability were identified by reviewing indemnity service records and medical bills using a comprehensive list of codes from the International Classification of Diseases, Ninth Edition (ICD-9) indicating LBP or nonspecific back pain, excluding medically complicated cases.

resultsWe found significant between-state variations in the negative impact of eMRI on LOD ranging from 3.4 days in Tennessee to 14.8 days in New Hampshire. Higher negative impact of eMRI on LOD was mainly associated with female gender, state workers' compensation (WC) policy not limiting initial treating provider choice, higher state orthopedic surgeon density, and lower state MRI facility density.

conclusionState WC policies regulating selection of healthcare provider and structural factors affecting quality of medical care modify the impact of eMRI not adherent to guidelines. Targeted healthcare and work disability prevention interventions may improve work disability outcomes in patients with occupational LBP.

Indexed as

Health PersonnelAdultCohort StudiesFemaleHumansLow Back PainMagnetic Resonance ImagingMaleMiddle AgedOccupational DiseasesRetrospective StudiesUnited StatesWorkers' CompensationCohort studyGeographic variation in careLow back painMagnetic resonance imagingWork disability

Identifiers

PMID31785613
PMCPMC6885323
OpenAlexW2993336453

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.