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During the acute back pain episode,46%of patients had a radiography and 9% had CT or MRI.Patient variables related to the use of radiography included pain that began more than 2 weeks before the index visit and no previous episodes of low back pain.Practitioner variables associated with the use of radiography were being a chiropractor or orthopedic surgeon and having a private practice.Use of CT or MRI was associate with white race, neurologic deficit at baseline,sciatica,poor functional status at baseline and small group practice size.Practitioners'responses to clinical vignettes were associated with aggregate practitioner behavior:In the vignettes and in real life,practitioners were more likely to order CT for patients with sciatica.However,a practitioner's response to a vignette did not predict that practitioner's use of CT or MRI for similar patients in his or her own practice.Radiography is commonly used as a diagnostic test for patients with acute back pain.Clinical factors and provider specialty are major correlates of the use of imaging studies. |
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