ArticleInternational journal for quality in health care : journal of the International Society for Quality in Health Care2021
Combined lumbar spine MRI and CT appropriateness checklist: a quality improvement project in Saskatchewan, Canada.
Article in International journal for quality in health care : journal of the International Society for Quality in Health Care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Reducing inappropriate lumbar MRI referrals: a Danish pre- and post-intervention study.Chiropractic & manual therapies · 2026Article
- Radiomics in Gastric Cancer: Advancing Precision Medicine.Journal of gastric cancer · 2026Review
- The growing burden of spine surgical wait times: a retrospective cohort study of longitudinal trends and impact on perioperative outcomes.Canadian journal of surgery. Journal canadien de chirurgieArticle
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Authors and funding
5 authors.
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Abstract
backgroundAs rates of advanced imaging for lower back pain (LBP) continue to increase, there is a need to ensure the appropriateness of imaging.
objectiveThe goal of this project was to reduce the number of inappropriate magnetic resonance imaging (MRI) and computed tomography (CT) requests for LBP patients and facilitate appropriate imaging by developing a combined imaging appropriateness checklist for lumbar spine MRI and CT.
methodsIn prior work, we developed and adopted individual evidence-based lumbar spine MRI and CT checklists into the radiology requisition process. In the current project, a combined checklist was developed and trialed in one of the former Saskatchewan health regions (Five Hills) beginning in May 2018. Using statistical process control, control charts compared the monthly number of imaging requests pre-checklist implementation and post-checklist implementation from May 2017 to February 2020. The monthly number of lumbar spine MRI and CT requisitions in the nearby former Saskatchewan Regina Qu'Appelle Health Region, in which the combined checklist was not trialed, was also plotted and compared as a balancing measure.
resultsIn Five Hills, a shift (decrease) was observed in the monthly number of lumbar spine MRI requisitions 7 months following the implementation of the combined checklist. However, the monthly number of lumbar spine CT requisitions did not change significantly. In the Regina Qu'Appelle Health Region, there was a shift (increase) in the monthly number of lumbar spine MRI requisitions, while the monthly number of lumbar spine CT requests decreased after the implementation of the combined checklist.
conclusionsThe combined checklist with evidence-based indications for lumbar spine MRI and CT imaging in LBP patients appeared to reduce the complexity associated with two previous individual checklists and facilitate imaging appropriateness. Accountable benefits may include the reduction of radiation exposure as a result of unnecessary and repeated imaging and reduction in wait times for CT and/or MRI.
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