title: Lumbar MR imaging and reporting epidemiology: do epidemiologic data in reports affect clinical management?
abstract: OBJECTIVE
  To retrospectively examine the association between the inclusion of epidemiologic information in lumbar spine magnetic resonance (MR) imaging reports regarding findings in asymptomatic individuals and the rates of subsequent cross-sectional imaging and treatments in patients with low back pain or radiculopathy referred for imaging by primary care providers.
  
  
  METHODS
  Institutional review board approval was received for a retrospective chart review, with waiver of informed consent and HIPAA authorization. During 3 years, an epidemiologic statement was routinely but arbitrarily included in lumbar spine MR imaging reports. Two hundred thirty-seven reports documenting uncomplicated degenerative changes on initial lumbar spine MR images were identified, 71 (30%) of which included the statement (statement group) and 166 (70%) did not (nonstatement group). The rates of repeat cross-sectional imaging and treatments within 1 year were compared between groups by using logistic regression controlling for severity of MR imaging findings.
  
  
  RESULTS
  Patients in the statement group were significantly less likely to receive a prescription for narcotics for their symptoms than patients in the nonstatement group (odds ratio = 0.29, P = .01). Repeat cross-sectional imaging and physical therapy referrals were also less common in the statement group than in the nonstatement group (odds ratio = 0.22 and 0.55, respectively), but these differences were not statistically significant (P = .14 and .06, respectively). Rates of steroid injections, surgical consultations, and surgeries were similar between groups.
  
  
  CONCLUSIONS
  Patients were less likely to receive narcotics prescriptions from primary care providers when epidemiologic information was included in their lumbar spine MR imaging reports.
authors.affiliation: Department of Radiology and Neurologic Surgery, School of Medicine, University of Washington, Box 357115, 1959 NE Pacific St, Seattle, WA 98195, USA.
authors.forename: Brendan J
authors.initials: BJ
authors.lastname: McCullough
authors.forename: Germaine R
authors.initials: GR
authors.lastname: Johnson
authors.forename: Brook I
authors.initials: BI
authors.lastname: Martin
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Jarvik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data; D011843:Radiculopathy / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D009294:Narcotics