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October 8, 2003

The Value of Diagnostic Tests for Low Back Pain—ReplyThe Value of Diagnostic Tests for Low Back Pain—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(14):1851-1853. doi:10.1001/jama.290.14.1851-a

In Reply: We agree with Dr Caplan that there is value in a diagnostic test beyond that measured by functional outcomes alone. That is why we measured not only back-related disability and general health-related quality of life but also the confidence that physicians had in their diagnoses, differences in therapy, and the degree of reassurance that patients received from the diagnostic test. We found an advantage of MRI over radiographs in several of these areas. But these benefits come at a real cost to patients, the medical system, and society as a whole. Ultimately, the goal of a diagnostic test is to improve a patient's health and well-being, albeit via changes in diagnosis and therapy.

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