ArticleJournal of general internal medicine2020
Effects of Physician Experience, Specialty Training, and Self-referral on Inappropriate Diagnostic Imaging.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 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
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review: Association Between Physicians' Clinical Experience and Quality of Care and Patient Outcomes.Journal of general internal medicine · 2026Pooled it
- Clinical experience of the attending doctor matters: diagnosing anastomotic leakage after colorectal surgery.Surgical endoscopy · 2026Article
- Evaluating acute image ordering for real-world patient cases via language model alignment with radiological guidelines.Communications medicine · 2025Article
- Deep Learning-Based DCE-MRI Automatic Segmentation in Predicting Lesion Nature in BI-RADS Category 4.Journal of imaging informatics in medicine · 2025Article
- Assessing Fracture Detection: A Comparison of Minimal-Resource and Standard-Resource Plain Radiographic Interpretations.Diagnostics (Basel, Switzerland) · 2025Article
- Evaluating the Accuracy and Impact of the ESR-iGuide Decision Support Tool in Optimizing CT Imaging Referral Appropriateness.Journal of imaging informatics in medicine · 2025Article
- Delayed-onset hearing loss in first-grade students who previously passed the newborn hearing screening.Frontiers in pediatrics · 2025Article
- Inappropriate CT examinations: how much, who and where? Insights from a clinical decision support system (CDSS) analysis.European radiology · 2023Article
- Does clinical decision support system promote expert consensus for appropriate imaging referrals? Chest-abdominal-pelvis CT as a case study.Insights into imaging · 2023Article
- Costs of Specialist Referrals From Employer-Sponsored Integrated Health Care Clinics Are Lower Than Those From Community Providers.Journal of general internal medicine · 2022Article
- The age-old question: Thematic analysis of focus groups on physician experiences of aging in emergency medicine.Journal of the American College of Emergency Physicians open · 2021Article
- Capsule Commentary on Young et al., Effects of Physician Experience, Specialty Training, and Self Referral on Inappropriate Diagnostic Imaging.Journal of general internal medicine · 2020Article
- Knowledge, practices, and challenges in primary care management of dizziness and vertigo in Saudi Arabia.Frontiers in neurologyArticle
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough previous research has demonstrated high rates of inappropriate diagnostic imaging, the potential influence of several physician-level characteristics is not well established.
objectiveTo examine the influence of three types of physician characteristics on inappropriate imaging: experience, specialty training, and self-referral.
designA retrospective analysis of over 70,000 MRI claims submitted for commercially insured individuals. Physician characteristics were identified through a combination of administrative records and primary data collection. Multi-level modeling was used to assess relationships between physician characteristics and inappropriate MRIs.
settingMassachusetts
participantsCommercially insured individuals who received an MRI between 2010 and 2013 for one of three conditions: low back pain, knee pain, and shoulder pain. MEASUREMENTS: Guidelines from the American College of Radiology were used to classify MRI referrals as appropriate/inappropriate. Experience was measured from the date of medical school graduation. Specialty training comprised three principal groups: general internal medicine, family medicine, and orthopedics. Two forms of self-referral were examined: (a) the same physician who ordered the procedure also performed it, and (b) the physicians who ordered and performed the procedure were members of the same group practice and the procedure was performed outside the hospital setting.
resultsApproximately 23% of claims were classified as inappropriate. Physicians with 10 or less years of experience had significantly higher odds of ordering inappropriate MRIs. Primary care physicians were almost twice as likely to order an inappropriate MRI as orthopedists. Self-referral was not associated with higher rates of inappropriate MRIs. LIMITATIONS: Classification of MRIs was conducted with claims data. Not all self-referred MRIs could be detected.
conclusionsInappropriate imaging continues to be a driver of wasteful health care spending. Both physician experience and specialty training were highly associated with inappropriate imaging.
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.