Rockey P H, Tompkins R K, Wood R W, Wolcott B W
J Fam Pract. 1978 Sep;7(3):455-65.
Process and outcome data from 440 patients with back pain were analyzed. As a part of their care, 106 patients (24 percent) had back x-ray examinations. The non-x-rayed group of patients was used as a naturally occurring control group to determine what contribution back radiographs made to the cost, to the diagnoses and therapeutic decisions of providers, and to the outcome and satisfaction of patients. Although back x-rays contributed more to the cost of patient care than any other diagnostic study, their contribution to diagnosis was minimal, and had little effect on therapeutic decisions. Patients receiving back x-rays were more likely to have had prolonged symptoms at their first visit, and less likely to be symptom-free at four weeks, but were more likely to be satisfied with their care. The authors conclude that, for patients under 50, back x-ray examinations have negligible diagnostic value and their use could be reduced without decreasing the quality of medical care.
对440例背痛患者的诊疗过程及结果数据进行了分析。作为其治疗的一部分，106例患者（24%）接受了背部X光检查。未接受X光检查的患者组作为自然形成的对照组，以确定背部X光片对医疗费用、医疗服务提供者的诊断和治疗决策以及患者的治疗结果和满意度有何贡献。尽管背部X光检查比其他任何诊断检查对患者护理费用的贡献都更大，但其对诊断的贡献极小，对治疗决策的影响也很小。接受背部X光检查的患者首次就诊时症状持续时间更长，四周时无症状的可能性更小，但对其护理更满意。作者得出结论，对于50岁以下的患者，背部X光检查的诊断价值可忽略不计，减少其使用不会降低医疗质量。
