Table 2:

Summary of findings for inserting prevalence information into imaging reports versus standard reportsa

Study/No. of ParticipantsGRADE RatingFollow-Up PeriodOutcomeHealth Care Use or Cost, Outcome MeasureEffectOR, 95% CI, or Rate Ratio (P Value)
Jarvik et al, 202021N = 238,886cModerateShort-termWritten opioid prescriptionOR = 0.95 (0.90–0.99)b
Marcum et al, 202125N = 170,680cModerateShort-termNew prescription for nonopioid pain-related medicationsdOR = 1.02 (0.97–1.08)b
Jarvik et al, 202021N = 238,886cModerateLong-termWritten opioid prescriptionOR = 0.95 (0.91–1.00)b
Suri et al, 202126N = 238,886cModerateLong-termNonsurgical procedureseAny spine surgeryOR = 1.01 (0.93–1.09)bOR = 0.99 (0.91–1.07)b
Weeks et al, 202024N = 6904Very lowLong-termPrimary care visitsChiropractic care visitsPhysical therapy care visitsSpecialty care visitsNerve-conduction testsMR imaging testingNon-MR imagingFacet injectionOn an opioidOn a muscle relaxantNonfusion spine surgeryRate ratio = 0.86 P = NSfRate ratio = 1.37 P = .05f
Rate ratio = 1.19 P = NSf
Rate ratio = 0.95 P = NSf
Rate ratio = 0.57 P = .05f
Rate ratio = 0.89 P = NSf
Rate ratio = 0.73 P = .04f
Rate ratio = 0.71 P = .02f
Rate ratio = 0.98 P = NSf
Rate ratio = 0.82 P = NSf
Rate ratio = 0.71 P = NSf
Fusion spine surgeryRate ratio = 0.76 P = NSf
Weeks et al, 202024N = 6904Very lowLong-termCost, total spine-related per member per month expendituresRate ratio = 0.85 P = NSf
  • Note:—NS indicates not significant.

  • a Dichotomous outcomes are shown. A rate ratio of <1 represents an effect in favor of the intervention group.

  • b Adjusted for health system, clinic size, age range, sex, imaging technique, Charlson Comorbidity Index category, seasonality, and health-specific trends. Results of opioid prescription additionally adjusted for prior opioid use. Results of nonsurgical procedures additionally adjusted for nonsurgical use in the year preceding index imaging.

  • c Articles reporting outcomes from the same study.

  • d Nonopioid, pain-related medications including skeletal muscle relaxants, NSAIDs, gabapentenoids, tricyclic antidepressants, and benzodiazepines.

  • e Procedures include lumbosacral epidural steroid injection, facet joint injection, facet join radiofrequency ablation, or sacroiliac injection.

  • f Adjusted for age, sex, line of business, deductible, and forecasted risk score at the time of first MR imaging.