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June 1982

Roentgenograms in Primary Care Patients With Acute Low Back Pain: A Cost-effectiveness Analysis

Author Affiliations

From the Laboratory for the Analysis of Medical Practices (LAMP) (Dr Komaroff), the Division of General Medicine and Primary Care, Department of Medicine (Drs Liang and Komaroff), and the Robert B. Brigham Multipurpose Arthritis Center, Brigham and Women's Hospital, Harvard Medical School (Dr Liang); and the Center for the Analysis of Health Practices (Dr Komaroff), Harvard School of Public Health (Drs Liang and Komaroff), Boston.

Arch Intern Med. 1982;142(6):1108-1112. doi:10.1001/archinte.1982.00340190064013

• For patients visiting a primary care office practice for acute low back pain, we compared the benefits, risks, and costs of obtaining a roentgenogram of the lumbar spine routinely at the initial visit with performing a roentgenogram only if the patient's pain does not improve during an eight-week follow-up period. The cost-effectiveness analysis indicated that, to avert one day of physical suffering in a population of patients, the population would have to be subjected to the additional risk of 3,188 mrad of radiation and an additional cost of $2,072. While, in the individual case, circumstances might lead to a different conclusion, in general, the risks and costs of obtaining lumbar roentgenograms at the initial visit in patients with acute low back pain do not seem to justify the relatively small associated benefit.

(Arch Intern Med 1982;142:1108-1112)

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