ArticleInsights into imaging2023
The use of low-value imaging: the role of referral practice and access to imaging services in a representative area of Norway.
Article in Insights into imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Impact and effect of imaging referral guidelines on patients and radiology services: a systematic review.European radiology · 2025Pooled it
- Variations in general practitioners' referrals to low-value MRI examinations in Norway: A nationwide register-based study.The European journal of general practice · 2026Article
- Drivers and potential mitigation solutions for low-value medical imaging in Iran: a qualitative study.BMJ open · 2026Article
- Temporal and geographical variations in musculoskeletal imaging: a register-based study in Norway with focus on potential low-value imaging.Research in health services & regions · 2025Article
- Geographical variations and potential low-value neuroimaging examinations in Norway from 2013 to 2022.Research in health services & regions · 2025Article
- Temporal and geographical variations in diagnostic imaging in Norway.BMC health services research · 2024Article
- Hospitalizations and re-hospitalizations at the end-of-life among cancer patients; a retrospective register data study.BMC palliative care · 2024Article
- Patient flow analysis with fast-track MRI for suspected stroke in the emergency department and associated non-comprehensive stroke center.Therapeutic advances in neurological disorders · 2024Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundEven though imaging is essential to modern medicine, some examinations are of low value as they do not lead to any change in the management of the patient. The Choosing Wisely (CW) campaign aims to reduce the use of such services. In the Norwegian version of CW, specific magnetic resonance imaging (MRI) of the head, lower back, and knee are amongst others identified as potential low-value examinations. However, referral practice and access to imaging may drive low-value utilisation. By using registry data from 2019 and descriptive analysis, this study aimed to examine the role of referral practice and access to imaging on the use of specific CW-examinations in one representative area in Norway.
resultsA total of 237,554 examinations were performed by four public and two private imaging facilities located within the area. Forty-two percent (19,210/45,289) of all MRI examinations were related to CW. Private imaging centres performed most of the CW-imaging. A total of 3700 referrers were identified, and 2.3% were identified as "high-referrers," accounting for 33% of all CW-examinations. Referrers' experience did not influence imaging utilisation. A subset of referrers ("super-referrers," 0.5%) accounted for 10% of CW-examinations. Distance to service had no impact on the use of CW-examinations.
conclusionsThis study provides valuable insight into the use of imaging and referral practice in one representative area in Norway. A great variation in referral practice was observed. Therefore, targeting referrers with high referral rates may be a promising strategy for reducing the use of low-value imaging.
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