This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Cost-effectiveness Analysis

Matthew Liang, MD; Anthony L. Komaroff, MD

Arch Intern Med. 1982;142(6):1108-1112.

Abstract
• 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)

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.

Footnotes
Accepted for publication Feb 19, 1982.

Reprint requests to the LAMP, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (Dr Liang).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Preferences for oral health states: effect on prescribing periapical radiographs
Mileman and van den Hout
Dentomaxillofac Radiol 2003;32:401-407.
ABSTRACT | FULL TEXT  

Diagnostic Evaluation of Low Back Pain with Emphasis on Imaging
Jarvik and Deyo
ANN INTERN MED 2002;137:586-597.
ABSTRACT | FULL TEXT  

Use of Lumbar Radiographs for the Early Diagnosis of Low Back Pain: Proposed Guidelines Would Increase Utilization
Suarez-Almazor et al.
JAMA 1997;277:1782-1786.
ABSTRACT  

Musculoskeletal Pain as an Indicator of Occult Malignancy: Yield of Bone Scintigraphy
Jacobson
Arch Intern Med 1997;157:105-109.
ABSTRACT  

What Can the History and Physical Examination Tell Us About Low Back Pain?
Deyo et al.
JAMA 1992;268:760-765.
ABSTRACT  

Low-Back Pain and Intravenous Drug Abusers-Reply
DEYO
Arch Intern Med 1990;150:1128-1130.
ABSTRACT  

Plain Roentgenography for Low-Back Pain: Finding Needles in a Haystack
DEYO
Arch Intern Med 1989;149:27-29.
ABSTRACT  

Selective Criteria May Increase Lumbosacral Spine Roentgenogram Use in Acute Low-Back Pain
Frazier et al.
Arch Intern Med 1989;149:47-50.
ABSTRACT  

Decision Analysis: A Progress Report
KASSIRER et al.
ANN INTERN MED 1987;106:275-291.
ABSTRACT  

Reducing Roentgenography Use: Can Patient Expectations Be Altered?
Deyo et al.
Arch Intern Med 1987;147:141-145.
ABSTRACT