Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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.
Jarvik JG, Deyo RA, Hollingworth W. The Value of Diagnostic Tests for Low Back Pain—ReplyThe Value of Diagnostic Tests for Low Back Pain—Reply. JAMA. 2003;290(14):1851-1853. doi:10.1001/jama.290.14.1851-a