Department of Radiology, School of Medicine, University of Washington, Seattle, WA 98104-2499, USA.
AJR Am J Roentgenol. 2010 Sep;195(3):550-9. doi: 10.2214/AJR.10.4367.
Low back pain is one of the most common causes of physician visits in the United States with an enormous socioeconomic burden. Because of this burden, numerous studies have focused on its diagnosis and management. New technologies have been quickly adopted with the hope that they will improve our understanding of the physiopathology of the disease and assist us in alleviating patients' pain and discomfort. Unfortunately, previous studies have not been able to show that higher utilization of advanced imaging technology is associated with improvements in patient outcome. This article highlights practices that are evidence-based versus those that are common, or heterogeneous, but not supported by existing evidence. We also highlight outstanding areas for further research.
Clinicians and researchers should be encouraged to follow standardized practices in accordance with evidence-based medicine guidelines. The use of such guidelines will decrease variation in care, allowing researchers to more easily design and conduct comparative effectiveness studies of diagnostic imaging.
腰痛是美国医生就诊最常见的原因之一,给社会经济带来了巨大负担。由于这种负担,许多研究都集中在其诊断和管理上。新技术已迅速被采用,希望它们能帮助我们更好地理解疾病的病理生理学,并帮助我们减轻患者的痛苦和不适。不幸的是,以前的研究未能表明更多地利用先进的成像技术与改善患者的预后相关。本文强调了基于证据的实践与常见或异质的实践之间的差异,后者没有得到现有证据的支持。我们还强调了进一步研究的突出领域。
应鼓励临床医生和研究人员根据循证医学指南遵循标准化的实践。使用此类指南将减少护理中的差异,使研究人员能够更轻松地设计和开展诊断成像的比较效果研究。