Led by Dr. Anthony Aquino, a diagnostic radiology resident at Ohio State University Wexner Medical Center, the researchers used American College of Radiology (ACR) appropriate use criteria to assess whether adequate data were provided for the scans.
The retrospective study analyzed 96 outpatient MRI scans of the lumbar spine for back pain. Each MRI scan was recategorized into one of six variables, which included potential red flags based on the ACR's appropriate use criteria. Compliance with ACR standards was rated on a scale of 1 to 9, with 1 to 3 considered "usually not appropriate" and 7 to 9 considered "usually appropriate."
After reviewing the medical records, the researchers found that 80% of studies had a rating of at least 7. However, when they reviewed the clinician-provided "Reason for Exam" or "Ordering Comments," only 26% of the exams were deemed "usually appropriate."
Most lumbar spine MRI examinations for low-back pain are appropriately based on ACR appropriate use criteria, Aquino and colleagues concluded. But a "large portion of appropriate examinations could be falsely deemed inappropriate if only the information provided by the clinician at order entry is evaluated," they added in their abstract.
To correct the deficiencies, they recommended better communication of relevant clinical information from referring providers to ensure more appropriate use of MRI for lumbar spine scans.
