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Research Letter
Less Is More
December 2016

Clinicians’ Perceptions of Barriers to Avoiding Inappropriate Imaging for Low Back Pain—Knowing Is Not Enough

Author Affiliations
  • 1Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan
  • 2Department of Surgery, University of Michigan Health System, Ann Arbor
  • 3Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
  • 4Department of Internal Medicine, University of Michigan Health System, Ann Arbor
  • 5Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City
  • 6Veterans Affairs Salt Lake City Center for Informatics Decision Enhancement and Surveillance (IDEAS), Salt Lake City, Utah
  • 7Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor
JAMA Intern Med. 2016;176(12):1866-1868. doi:10.1001/jamainternmed.2016.6364

Overuse of imaging for low back pain (LBP) is a considerable problem. Approximately 31% of lumbosacral magnetic resonance imaging (MRI) scans performed were deemed inappropriate in the Department of Veterans Affairs (VA),1 and similar rates of inappropriate MRI use have been seen outside of the VA.2 Seven Choosing Wisely (CW) campaign recommendations support not ordering imaging tests for patients with nonspecific LBP.3 Our objective was to determine what clinicians perceive to be barriers to following the CW recommendations to avoid ordering imaging tests for nonspecific LBP.

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