Early imaging for back pain in older adults not associated with better outcomes

SAN FRANCISCO — Early imaging of older adults who visited their primary care physicians for new back pain may not lead to better treatment and may be a waste of resources, according to study findings.

“Among older adults going to a primary care physician for new back pain, early imaging was not associated with better outcomes in terms of disability, pain, or quality of life, but was associated with greater resource utilization,” Richard A. Deyo, MD, said at the International Society for the Study of the Lumbar Spine Annual Meeting.

The prospective cohort study analyzed 3,000 patients visiting their primary care physician (PCP) for new back pain. Patients were excluded if they had visited their PCP within the previous 6 months for back pain.

Richard A. Deyo

Deyo and colleagues used the Roland-Morris Disability scale and relative value units (RVUs) as a measure of health care utilization as the primary outcomes for their study. They found older patients who underwent early imaging had no statistically significant differences in disability, back and leg pain, and EuroQol-5D outcomes vs. patients who did not undergo early imaging.

“The only important difference was a much higher utilization in resources in patients that had the early imaging tests. It is a highly significant difference of 22 RVUs, which amounts to a difference of $1,300,” he said.

Earlier imaging tended to lead to unnecessary interventions, such as physical therapy and injections, according to Deyo. – by Robert Linnehan

Reference:

Jarvik JG, et al. Paper #24. Presented at: International Society for the Study of the Lumbar Spine Annual Meeting; June 8-12, 2015; San Francisco.

Disclosure: Deyo reports no relevant financial disclosures.