Wednesday, 18 March 2015

Early Scans for Back Pain May Do Little to Help Seniors


Researchers saw no difference in outcomes, even though more money was spent on treatments

WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

TUESDAY, March 17, 2015 (HealthDay News) -- Most current guidelines suggest that when seniors report new back pain to their primary care physician they should quickly be sent for diagnostic imaging, such as CT scans or MRIs.

But a new study suggests that early imaging may actually be a waste of both time and money.

"Older adults with back pain who seek care and get imaging within six weeks of their doctors visit for back pain do not have better outcomes than similar older adults who do not get early imaging," said study author Dr. Jeffrey Jarvik. He is a professor of radiology, neurological surgery and health services at the University of Washington, in Seattle.

In fact, Jarvik noted that "although early imaging is not associated with better pain and function outcomes, it is associated with greater use of health care services, such as visits [and] injections." And that, he said, "translates into a nearly $1,500 per patient additional cost, for no measurable benefit."

"This is the opposite of 'high-value health care,' " said Jarvik, who's also an adjunct professor in health services, pharmacy, and orthopedics and sports medicine at the university. "No benefit at great cost."

Jarvik reports his team's findings in the March 17 issue of the Journal of the American Medical Association.

The researchers noted that the American College of Radiology guidelines state that early MRIs are "appropriate" for patients aged 70 and up, as well as for osteoporosis patients aged 50 and older.

To assess the impact of early back scanning on back pain management among seniors, the study authors focused on more than 5,200 patients over the age of 65 who sought care between 2011 and 2013 for a fresh bout of lower back pain.

Of those, more than 1,500 were sent for some form of back imaging within six weeks of their initial doctor's visit.

The team then reviewed electronic medical records to tally what kind of services patients used in the year following their first doctor's visit. They also analyzed responses the seniors gave in a back and leg pain disability questionnaire.

source : Early Scans for Back Pain May Do Little to Help Seniors

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