Older people with back pain who received early x-rays, CT scans or MRIs were no better off a year later than others who didn’t receive initial imaging tests, a new study finds.
They also ended up with higher medical bills, according to the study, published in the Journal of the American Medical Association. The research was led by Dr. Jeffrey Jarvik, professor of health services at the University of Washington School of Public Health; professor of radiology and neurological surgery in the School of Medicine; and director of the UW’s Comparative Effectiveness, Cost and Outcomes Research Center.
When to image older adults with low back pain remains controversial, researchers say. Many guidelines recommend imaging right away, but there’s a lack of evidence to support those recommendations. Most guidelines do not recommend immediate imaging for younger patients because most people recover from back pain within a few weeks, and imaging could end up leading to costly interventions that might cause more harm than good.
Dr. Jarvik and colleagues studied more than 5,200 patients 65 and older who sought new care for back pain. They identified more than 1,500 patients who had either an x-ray or MRI/CT scan within six weeks of their first visit for the problem.
One year later, there were no statistically significant differences in pain or disability between those who had early imaging tests and those who didn’t. Health care costs, however, were about 30 percent higher for those who had the initial imaging tests – an average $1,380 higher for patients who had early x-rays and $1,430 higher for those who had early MRI/CTs.
“Regardless of age, early imaging should not be performed routinely,” the researchers write in JAMA.
Other co-authors from the School of Public Health included members of the departments of biostatistics and health services.