Evidence map›Paper›PMID 34046738›Full record

Observational studySkeletal radiology2021

Observer agreement in the choice of lumbar spine injection for pain management.

Rene Balza, Sarah F Mercaldo, Connie Y Chang, Ambrose J Huang, Jad S Husseini, Arvin B Kheterpal, F Joseph Simeone, William E Palmer

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Skeletal radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 46% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
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

8 authors at 1 institution in 1 country.

Rene BalzaDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street YAW 6030, Boston, MA, 02114, USA.
Sarah F MercaldoDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street YAW 6030, Boston, MA, 02114, USA.
Connie Y ChangDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street YAW 6030, Boston, MA, 02114, USA.
Ambrose J HuangDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street YAW 6030, Boston, MA, 02114, USA.
Jad S HusseiniDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street YAW 6030, Boston, MA, 02114, USA.
Arvin B KheterpalDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street YAW 6030, Boston, MA, 02114, USA.
F Joseph SimeoneDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street YAW 6030, Boston, MA, 02114, USA.
William E PalmerDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street YAW 6030, Boston, MA, 02114, USA. wpalmer@mgh.harvard.edu.ORCID http://orcid.org/0000-0002-8278-6232
Harvard University · US

Funding

Ralph Schlaeger Research Fellowship Grant MGH Radiology Department grant
6 · The paper itself

Abstract

background and purposeLumbar spine MRI can help guide the choice of corticosteroid injection in pain management. We investigated whether patient-reported symptom information from a questionnaire could improve agreement in the choice of type, level, and side of injection. MATERIALS AND

methodsIn this prospective observational study, 120 patients (median age 64, 70 men) were recruited from patients referred for pain management. After informed consent, they completed electronic questionnaires that obtained symptom information for later use during MRI reviews. In 3 research arms, 6 radiologists chose injections that would ideally deliver corticosteroid to the presumed sources of pain in (1) MRI studies reviewed with symptom information from questionnaires, (2) MRI studies reviewed without symptom information, and (3) MRI reports. Blinded to questionnaire results, radiologists providing clinical care and interviewing patients chose ideal therapeutic injections to establish reference standards. Injections were categorized by type, level, and side and compared using percent agreement and kappa statistics. Interreading agreement was analyzed.

resultsCompared to the reference standard, kappa agreements for injection types, levels, and sides were almost perfect when MRIs were reviewed knowing symptoms (0.85-0.93), fair without symptoms (0.23-0.35) (all P < .001) and fair in MRI reports (0.24-0.36) (all P < .001). Interreading kappa agreements were almost perfect knowing symptoms (0.82-0.90), but only moderate without symptoms (0.42-0.49) (all P < .001).

conclusionsRadiologists reviewing lumbar spine MRI converged on the type, level, and side of ideal therapeutic injection whether they obtained symptom information from direct patient interview or electronic questionnaire. Observer agreement was significantly lower without symptom information.

Indexed as

Lumbar VertebraePain ManagementHumansLumbosacral RegionMagnetic Resonance ImagingMaleMiddle AgedObserver VariationProspective StudiesMRIPain managementSpine

Identifiers

PMID34046738
OpenAlexW3164267734

What OpenQuestion holds

Textmetadata
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.