Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis
<h2>Background</h2> <p>Early magnetic resonance imaging (eMRI) for nonspecific low back pain (LBP) not adherent to clinical guidelines is linked with prolonged work disability. Although the prevalence of eMRI for occupational LBP varies substantially among states, it is unknown whe...
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2019
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| _version_ | 1864513552241393664 |
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| author | Mujahed Shraim (14153145) |
| author2 | Manuel Cifuentes (331123) Joanna L. Willetts (3178983) Helen R. Marucci-Wellman (3178977) Glenn Pransky (718525) |
| author2_role | author author author author |
| author_facet | Mujahed Shraim (14153145) Manuel Cifuentes (331123) Joanna L. Willetts (3178983) Helen R. Marucci-Wellman (3178977) Glenn Pransky (718525) |
| author_role | author |
| dc.creator.none.fl_str_mv | Mujahed Shraim (14153145) Manuel Cifuentes (331123) Joanna L. Willetts (3178983) Helen R. Marucci-Wellman (3178977) Glenn Pransky (718525) |
| dc.date.none.fl_str_mv | 2019-11-30T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1186/s12891-019-2964-7 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Why_does_the_adverse_effect_of_inappropriate_MRI_for_LBP_vary_by_geographic_location_An_exploratory_analysis/21598344 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Cohort study Low back pain Work disability Geographic variation in care Magnetic resonance imaging |
| dc.title.none.fl_str_mv | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h2>Background</h2> <p>Early magnetic resonance imaging (eMRI) for nonspecific low back pain (LBP) not adherent to clinical guidelines is linked with prolonged work disability. Although the prevalence of eMRI for occupational LBP varies substantially among states, it is unknown whether the risk of prolonged disability associated with eMRI varies according to individual and area-level characteristics. The aim was to explore whether the known risk of increased length of disability (LOD) associated with eMRI scanning not adherent to guidelines for occupational LBP varies according to patient and area-level characteristics, and the potential reasons for any observed variations.</p> <h2>Methods</h2> <p>A retrospective cohort of 59,360 LBP cases from 49 states, filed between 2002 and 2008, and examined LOD as the outcome. LBP cases with at least 1 day of work disability were identified by reviewing indemnity service records and medical bills using a comprehensive list of codes from the International Classification of Diseases, Ninth Edition (ICD-9) indicating LBP or nonspecific back pain, excluding medically complicated cases.</p> <h2>Results</h2> <p>We found significant between-state variations in the negative impact of eMRI on LOD ranging from 3.4 days in Tennessee to 14.8 days in New Hampshire. Higher negative impact of eMRI on LOD was mainly associated with female gender, state workers’ compensation (WC) policy not limiting initial treating provider choice, higher state orthopedic surgeon density, and lower state MRI facility density.</p> <h2>Conclusion</h2> <p>State WC policies regulating selection of healthcare provider and structural factors affecting quality of medical care modify the impact of eMRI not adherent to guidelines. Targeted healthcare and work disability prevention interventions may improve work disability outcomes in patients with occupational LBP.</p><h2>Other Information</h2> <p> Published in: BMC Musculoskeletal Disorders<br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1186/s12891-019-2964-7" target="_blank">http://dx.doi.org/10.1186/s12891-019-2964-7</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_634256ddc1dfed1184ee968507b66881 |
| identifier_str_mv | 10.1186/s12891-019-2964-7 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/21598344 |
| publishDate | 2019 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysisMujahed Shraim (14153145)Manuel Cifuentes (331123)Joanna L. Willetts (3178983)Helen R. Marucci-Wellman (3178977)Glenn Pransky (718525)Biomedical and clinical sciencesClinical sciencesCohort studyLow back painWork disabilityGeographic variation in careMagnetic resonance imaging<h2>Background</h2> <p>Early magnetic resonance imaging (eMRI) for nonspecific low back pain (LBP) not adherent to clinical guidelines is linked with prolonged work disability. Although the prevalence of eMRI for occupational LBP varies substantially among states, it is unknown whether the risk of prolonged disability associated with eMRI varies according to individual and area-level characteristics. The aim was to explore whether the known risk of increased length of disability (LOD) associated with eMRI scanning not adherent to guidelines for occupational LBP varies according to patient and area-level characteristics, and the potential reasons for any observed variations.</p> <h2>Methods</h2> <p>A retrospective cohort of 59,360 LBP cases from 49 states, filed between 2002 and 2008, and examined LOD as the outcome. LBP cases with at least 1 day of work disability were identified by reviewing indemnity service records and medical bills using a comprehensive list of codes from the International Classification of Diseases, Ninth Edition (ICD-9) indicating LBP or nonspecific back pain, excluding medically complicated cases.</p> <h2>Results</h2> <p>We found significant between-state variations in the negative impact of eMRI on LOD ranging from 3.4 days in Tennessee to 14.8 days in New Hampshire. Higher negative impact of eMRI on LOD was mainly associated with female gender, state workers’ compensation (WC) policy not limiting initial treating provider choice, higher state orthopedic surgeon density, and lower state MRI facility density.</p> <h2>Conclusion</h2> <p>State WC policies regulating selection of healthcare provider and structural factors affecting quality of medical care modify the impact of eMRI not adherent to guidelines. Targeted healthcare and work disability prevention interventions may improve work disability outcomes in patients with occupational LBP.</p><h2>Other Information</h2> <p> Published in: BMC Musculoskeletal Disorders<br> License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1186/s12891-019-2964-7" target="_blank">http://dx.doi.org/10.1186/s12891-019-2964-7</a></p>2019-11-30T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12891-019-2964-7https://figshare.com/articles/journal_contribution/Why_does_the_adverse_effect_of_inappropriate_MRI_for_LBP_vary_by_geographic_location_An_exploratory_analysis/21598344CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/215983442019-11-30T00:00:00Z |
| spellingShingle | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis Mujahed Shraim (14153145) Biomedical and clinical sciences Clinical sciences Cohort study Low back pain Work disability Geographic variation in care Magnetic resonance imaging |
| status_str | publishedVersion |
| title | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis |
| title_full | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis |
| title_fullStr | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis |
| title_full_unstemmed | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis |
| title_short | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis |
| title_sort | Why does the adverse effect of inappropriate MRI for LBP vary by geographic location? An exploratory analysis |
| topic | Biomedical and clinical sciences Clinical sciences Cohort study Low back pain Work disability Geographic variation in care Magnetic resonance imaging |