ArticleBMJ open2020
Clinician and patient beliefs about diagnostic imaging for low back pain: a systematic qualitative evidence synthesis.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
54 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Meta-Synthesis of the Experience of Chronic Temporomandibular Disorder Patients Within Health Care ServicesJournal of oral & facial pain and headache · 2023Pooled it
- Characteristics and Effectiveness of Interventions That Target the Reporting, Communication, or Clinical Interpretation of Lumbar Imaging Findings: A Systematic Review.AJNR. American journal of neuroradiology · 2022Pooled it
- One-Page Patient Fact Sheets for Low Back Pain in Primary Care: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Effect of diagnostic labelling on management intentions for non-specific low back pain: A randomized scenario-based experiment.European journal of pain (London, England) · 2022Trial
- Patient education booklet to support evidence-based low back pain care in primary care - a cluster randomized controlled trial.BMC family practice · 2021Trial
- Attitudes, Beliefs, and Clinical Decision-Making Regarding Low Back Pain: A Cross-Sectional Study of Pakistani Medical Practitioners, Physiotherapists, and Exercise Professionals.Musculoskeletal care · 2026Article
- Development and proof-of-concept of a complex intervention to support appropriate imaging for musculoskeletal pain: the Betti programme.Implementation science communications · 2026Article
- Why Most Australians Consider It Valuable to Find Harmless Abnormalities with Diagnostic Tests: A Mixed-Methods Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
- Drivers of unnecessary diagnostic imaging for uncomplicated low back pain among family physicians: a theory-informed qualitative study.Family practice · 2026Article
- Emergency physicians' perceptions and optimization strategies for diagnostic imaging overuse in Somalia.BMC emergency medicine · 2026Article
- Factors influencing referrals amongst allied health and medical practitioners managing people with musculoskeletal conditions in Australian primary care.BMC health services research · 2026Article
- Social determinants of health equity for people with pain: from understanding to action.Pain reports · 2026Article
- Implementation of a Self-Management Approach for Low Back Pain in a Public Health Care System.JAMA network open · 2026Article
- "It's hard to trust an individual, it's easier to trust an image"-patients with low back pain want imaging as a means of coping with uncertainty.BMC primary care · 2025Article
- Explainable AI reveals tissue pathology and psychosocial drivers of opioid prescription for non-specific chronic low back pain.Scientific reports · 2025Article
- Facilitators and barriers to deferring imaging for acute low back pain: a qualitative study.BMC primary care · 2025Article
- Australian General Practitioners' Use of Diagnostic Lumbar Spine Imaging for Patients With Acute Low Back Pain: A Qualitative Study.Musculoskeletal care · 2025Article
- Dissemination Strategies for Clinical Practice Guidelines Focused on Imaging for Low Back Pain: A Scoping Review.Musculoskeletal care · 2025Article
- Understanding patients' perceptions of uncomplicated low back pain: a theory-informed qualitative study using the Common-Sense Self-Regulation Model.BMC primary care · 2025Article
- Fostering Adherence to Evidence-Based Care in the Management of Musculoskeletal Shoulder Pain: A Mixed-Methods Study.Physical therapy · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveOveruse of diagnostic imaging for patients with low back pain remains common. The underlying beliefs about diagnostic imaging that could drive overuse remain unclear. We synthesised qualitative research that has explored clinician, patient or general public beliefs about diagnostic imaging for low back pain.
designA qualitative evidence synthesis using a thematic analysis.
methodsWe searched MEDLINE, EMBASE, CINAHL, AMED and PsycINFO from inception to 17 June 2019. Qualitative studies that interviewed clinicians, patients and/or general public exploring beliefs about diagnostic imaging for low back pain were included. Four review authors independently extracted data and organised these according to themes and subthemes. We used the Critical Appraisal Skills Programme tool to critically appraise included studies. To assess confidence in review findings, we used the GRADE-Confidence in the Evidence from Reviews of Qualitative Research method.
resultsWe included 69 qualitative studies with 1747 participants. Key findings included: Patients and clinicians believe diagnostic imaging is an important test to locate the source of low back pain (33 studies, high confidence); patients with chronic low back pain believe pathological findings on diagnostic imaging provide evidence that pain is real (12 studies, moderate confidence); and clinicians ordered diagnostic imaging to reduce the risk of a missed diagnosis that could lead to litigation, and to manage patients' expectations (12 studies, moderate confidence).
conclusionClinicians and patients can believe that diagnostic imaging is an important tool for locating the source of non-specific low back pain. Patients may underestimate the harms of unnecessary imaging tests. These beliefs could be important targets for intervention. PROSPERO REGISTRATION NUMBER: CRD42017076047.
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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.