title: Radiograph use in low back pain: a United States Emergency Department database analysis.
abstract: We identified factors associated with radiograph evaluation for patients who presented to the Emergency Department (ED) with uncomplicated low back pain (LBP). Using 1998-2000 ED data from the National Hospital Ambulatory Medical Care Survey, a multivariate analysis was performed to assess utilization of radiographs for LBP. Based upon published guidelines, of the over 3 million patients who met our criteria of uncomplicated LBP, 17.8% received an unnecessary radiograph. Patients who arrive via ambulance with moderate pain, who need to be seen within 15 min, and who have 3 or more screening tests ordered are 100% likely to also get a radiograph. There is an increased probability of receiving a radiograph for those patients 40-70 years old, being seen at a metropolitan hospital, having private insurance, and being treated by a resident in training. Multiple factors are associated with the overuse of radiographs for patients presenting with uncomplicated LBP.
authors.affiliation: Department of Clinical Research, College of Osteopathic Medicine, The University of Health Sciences, Kansas City, Missouri 64106, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Isaacs
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Marinac
authors.forename: Chao
authors.initials: C
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011859:Radiography; D012189:Retrospective Studies; D014481:United States