Factors Associated With Early Magnetic Resonance Imaging Utilization for Acute Occupational Low Back Pain

Details

• Alternative Title:
  Spine (Phila Pa 1976)
• Personal Author:
  Graves, Janessa M. ; Fulton-Kehoe, Deborah ; Martin, Diane P. ; Jarvik, Jeffrey G. ; Franklin, Gary M.
• Description:
  Study Design.
  
  A population-based, prospective cohort study.
  
  Objective.
  
  To identify demographic, job-related, psychosocial, and clinical factors associated with the use of magnetic resonance imaging (MRI) within 6 weeks from injury (early MRI) among workers’ compensation claimants with acute occupational low back pain (LBP).
  
  Summary of Background Data.
  
  Early MRI may be associated with increased use of services for treatment and costs. To understand utilization and most appropriately apply guidelines, it is important to identify factors associated with early imaging use for occupational LBP.
  
  Methods.
  
  Workers (N = 1830) were interviewed 3 weeks (median) after submitting a workers’ compensation claim for a back injury. Demographic, work, health, clinical, and injury characteristics were ascertained from interviews, medical records, and administrative data. Modified Poisson regression analyses identified factors associated with early MRI use.
  
  Results.
  
  Among respondents, 362 (19.8%) received an early MRI. Multivariable regression showed that male workers were 43% more likely to receive an early MRI than female workers (incident rate ratio [IRR]: 1.43, 95% confidence interval [CI]: 1.12–1.82). Initial visit type with a surgeon was associated with 78% greater likelihood of receiving an early MRI than that with a primary care physician (IRR: 1.78, 95% CI: 1.08–2.92). Having a chiropractor as the initial provider was associated with a reduced likelihood of early MRI (IRR: 0.53, 95% CI: 0.42–0.66). Workers with elevated work fear-avoidance, higher Roland scores, or increased injury severity were more likely to receive early MRI than counterparts with lower levels or scores.
  
  Conclusion.
  
  Nearly 20% of the injured workers with LBP receive early MRI, a rate similar to that reported elsewhere. Early MRI may lead to greater subsequent interventions, potentially poorer outcomes, and increased health care expenditures. On the basis of the characteristics of patients with uncomplicated occupational LBP, providers may be able to provide tailored care, and providers and policy makers may better understand the utilization of imaging and adherence to clinical guidelines.
  
  
• Subjects:
  Acute Disease Adult Article Clinical Practice Guidelines Diagnostic Imaging Disability Evaluation Early Diagnosis Early Imaging Emergency Service, Hospital Female Health Surveys Humans Low Back Pain Magnetic Resonance Imaging Male Manipulation, Chiropractic Medicine Middle Aged MRI Occupational Diseases Occupational Health Services Occupational Injuries Population-based Practice Guidelines As Topic Primary Health Care Prospective Studies Radiculopathy Socioeconomic Factors Washington Workers' Compensation Workers’ Compensation Young Adult

  More +
• Source:
  Spine (Phila Pa 1976). 37(19):1708-1718
• Pubmed ID:
  22020590
• Pubmed Central ID:
  PMC9626283
• Document Type:
  Journal Article
• Funding:
  R21 CE001850/CE/NCIPC CDC HHSUnited States/ ; R01 OH004069/OH/NIOSH CDC HHSUnited States/ ; 1 R0 OH04069/OH/NIOSH CDC HHSUnited States/ ; R01 HS019222-01/HS/AHRQ HHSUnited States/ ; 1 T42 OH008433/OH/NIOSH CDC HHSUnited States/
• Volume:
  37
• Issue:
  19
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:4640d0bc64fcecb552536e661181e69082bce4a021ab96bcac639cf83203fa60
• Download URL:
  https://stacks.cdc.gov/view/cdc/121998/cdc_121998_DS1.pdf
• File Type:
  [PDF - 390.34 KB ]