Jenkins H J, Hancock M J, Maher C G, French S D, Magnussen J S
Department of Health Professions, Macquarie University, Australia.
The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
Eur J Pain. 2016 Apr;20(4):573-80. doi: 10.1002/ejp.764. Epub 2015 Aug 18.
Imaging for low back pain (LBP) remains common despite guidelines recommending against routine imaging. Patient beliefs about imaging may contribute to the problem. This study aimed to quantitatively investigate patient beliefs regarding the need for imaging in managing LBP and to investigate whether personal characteristics, pain characteristics or back pain beliefs are associated with imaging beliefs.
A survey was performed of consecutive patients presenting to general medical practitioners in Sydney, Australia. Nine medical clinics were selected across varied socioeconomic regions. Survey questions assessed beliefs about the importance of imaging for LBP, collected demographic information, LBP history and general beliefs about back pain. Descriptive statistics and multivariate logistic regression were used to analyse findings.
Three hundred completed surveys were collected with a 79.6% response rate. The mean age was 44 years and 60.7% of respondents were women. Exactly, 54.3% (95% CI: 48.7-58.9%) believed that imaging was necessary for the best medical care for LBP. Exactly, 48.0% (95% CI: 42.4-53.6%) believed that everyone with LBP should obtain imaging. Increased age, lower education level, non-European or non-Anglo-saxon cultural background, history of previous imaging and Back Beliefs Questionnaire scores were associated with beliefs that imaging was necessary.
Approximately, half of all patients presenting to a medical doctor consider low back imaging to be necessary. This may have important implications for overutilization of low back imaging investigations. Knowledge of the factors associated with the patient's belief that imaging is necessary may be helpful in designing appropriate interventions to reduce unnecessary imaging for LBP.
尽管指南不建议进行常规成像检查，但针对腰痛（LBP）的成像检查仍然很常见。患者对成像检查的看法可能是导致这一问题的原因。本研究旨在定量调查患者对于腰痛管理中成像检查必要性的看法，并调查个人特征、疼痛特征或腰痛观念是否与成像检查观念相关。
对澳大利亚悉尼的全科医生接诊的连续患者进行了一项调查。在不同社会经济区域选择了9家医疗诊所。调查问题评估了对腰痛成像检查重要性的看法，收集了人口统计学信息、腰痛病史以及对腰痛的一般看法。采用描述性统计和多因素逻辑回归分析结果。
共收集到300份完整调查问卷，回复率为79.6%。平均年龄为44岁，60.7%的受访者为女性。确切地说，54.3%（95%可信区间：48.7 - 58.9%）的人认为成像检查对于腰痛的最佳医疗护理是必要的。确切地说，48.0%（95%可信区间：42.4 - 53.6%）的人认为每个腰痛患者都应该进行成像检查。年龄增加、教育水平较低、非欧洲或非盎格鲁 - 撒克逊文化背景、既往成像检查史以及背痛观念问卷得分与认为成像检查必要的观念相关。
前来就医的患者中约有一半认为腰椎成像检查是必要的。这可能对腰椎成像检查的过度使用具有重要影响。了解与患者认为成像检查必要相关的因素，可能有助于设计适当的干预措施，以减少对腰痛的不必要成像检查。
