Implementing evidence-based guidelines for radiography in acute low back pain: a pilot study in a chiropractic community.
OBJECTIVE
To evaluate the ability of a systematic educational intervention strategy to change the plain radiography ordering behavior of chiropractors toward evidence-based practice for patients with acute low back pain (LBP).


METHODS
A quasi-experimental method was used comparing outcomes before and after the intervention with those of a control community.


METHODS
Two communities in southern Ontario.


METHODS
Mailed survey data on the management of acute LBP. Outcome Measures Plain radiography use rates for acute LBP based on responses to mailed surveys.


RESULTS
Following the intervention, there was a 42% reduction in the self-report need for plain radiography for uncomplicated acute LBP (P <.025) and a 50% reduction for patients with acute LBP < 1 month (P <.025) in the intervention community. There was no significant change in the self-report need for plain radiography in the control community (P >.05).


CONCLUSIONS
The educational intervention strategy used in this study appeared to have an effect in reducing the perceived need for plain radiography in acute LBP.
Ammendolia
Carlo
C
Canadian Memorial Chiropractic College, and Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario M5G 2E9, Canada. cammendol@iwh.on.ca
Hogg-Johnson
Sheilah
S
Pennick
Victoria
V
Glazier
Richard
R
Bombardier
Claire
C
D000328:Adult; D001291:Attitude of Health Personnel; D002684:Chiropractic / Q000193:education / Q000592:standards; D004502:Education, Medical, Continuing / Q000592:standards*; D019317:Evidence-Based Medicine / Q000193:education / Q000592:standards; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009864:Ontario; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011859:Radiography / Q000706:statistics & numerical data; D011871:Radiology / Q000193:education; D011795:Surveys and Questionnaires