title: Awareness and use of diagnostic support tools for lumbar spinal stenosis in Japan.
abstract: BACKGROUND
  Lumbar spinal stenosis (LSS) is a major clinical problem associated with back pain, intermittent claudication, leg pain, and leg numbness. Diagnostic support tools for LSS such as the self-administered, self-reported history questionnaire (SSHQ) and developmental clinical diagnosis support tool (ST) have been validated in Japan. However, the degree of awareness and use of these two diagnostic support tools for LSS in Japan has not been clarified. The aims of the current study were to determine the degree of awareness and use of these two diagnostic support tools by Japanese physicians. Furthermore, we compared these results among nonorthopedic general practitioner (GP), orthopedic GP, and hospital-based orthopedic physicians.
  
  
  METHODS
  The LSS Diagnosis Support Tool (DISTO) Project was conducted to evaluate the degree of awareness and use of these two diagnostic support tools in Japan from 2011 to 2012. A total of 1,811 answers were obtained from physicians including nonorthopedic general practitioners (GP), orthopedic GPs, and hospital-based orthopedic physicians. Questions were (1) Do you know about these two diagnostic tools? and (2) If you know about these two diagnostic tools, have you used them?
  
  
  RESULTS
  The degree of awareness of ST and SSHQ was about 30 and 26 % by nonorthopedic GPs, 70 and 46 % by orthopedic GPs, and 68 and 41 % by hospital-based orthopedic physicians. The degree of awareness of ST and SSHQ by nonorthopedic GPs was significantly lower than by orthopedic GPs or hospital-based orthopedic physicians (p < 0.001). For physicians who were aware of ST and SSHQ, the degree of use of ST or SSHQ was <50 % by nonorthopedic GPs, orthopedic GPs, and hospital-based orthopedic physicians.
  
  
  CONCLUSIONS
  We expect that use of the ST or SSHQ tools in primary care will improve the accuracy of diagnosis and lead to improved quality of patient care. The low proportion of awareness by nonorthopedic GPs (<30 %) and use by all physicians (<50 %) indicate a need to encourage physicians to use ST and SSHQ more frequently.
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan, sohtori@faculty.chiba-u.jp.
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.forename: Miho
authors.initials: M
authors.lastname: Sekiguchi
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kakuma
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Konno
mesh_terms: D000368:Aged; D001364:Awareness; D003430:Cross-Sectional Studies; D006801:Humans; D007564:Japan; D008159:Lumbar Vertebrae; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012307:Risk Factors; D013130:Spinal Stenosis / Q000175:diagnosis*; D011795:Surveys and Questionnaires