Journal of Manipulative and Physiological Therapeutics
Volume 27, Issue 3 , Pages 170-179, March 2004

Implementing Evidence-Based Guidelines for Radiography in Acute Low Back Pain: A Pilot Study in a Chiropractic Community☆

  • Carlo Ammendolia, DC, MSc

      Affiliations

    • Corresponding Author InformationCarlo Ammendolia DC, MSc, Institute for Work & Health, 481 University Ave, Suite 800, Toronto, Ontario M5G 2E9, Canada
    • Canadian Memorial Chiropractic College, and Institute for Work & Health, Toronto, Ontario, Canada
  • Sheilah Hogg-Johnson, PhD

      Affiliations

    • Institute for Work & Health, and University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
    • ,
  • Claire Bombardier, MD, MSc

      Affiliations

    • Institute for Work & Health, and University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
  • Victoria Pennick, RN, MHSc

      Affiliations

    • Institute for Work & Health, Toronto, Ontario, Canada
  • Richard Glazier, MD, MPH

      Affiliations

    • University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada

Received 3 December 2002; received in revised form 2 January 2003

Abstract 

Objective

To evaluate the ability of a systematic educational intervention strategy to change the plain radiography ordering behavior of chiropractors toward evidence-based practice for patients with acute low back pain (LBP).

Design

A quasi-experimental method was used comparing outcomes before and after the intervention with those of a control community.

Setting

Two communities in southern Ontario.

Data Source

Mailed survey data on the management of acute LBP.

Outcome Measures

Plain radiography use rates for acute LBP based on responses to mailed surveys.

Results

Following the intervention, there was a 42% reduction in the self-report need for plain radiography for uncomplicated acute LBP (P < .025) and a 50% reduction for patients with acute LBP < 1 month (P < .025) in the intervention community. There was no significant change in the self-report need for plain radiography in the control community (P > .05).

Conclusions

The educational intervention strategy used in this study appeared to have an effect in reducing the perceived need for plain radiography in acute LBP.

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☆ This research was partially funded by the Chiropractic Foundation for Spinal Research.

PII: S0161-4754(03)00243-4

doi:10.1016/j.jmpt.2003.12.021

Journal of Manipulative and Physiological Therapeutics
Volume 27, Issue 3 , Pages 170-179, March 2004

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