Many requests for lower-back MRIs aren’t necessary, and steps should be taken to free-up testing for those who truly need it, new local research suggests.
Researchers from the University of Alberta were among a national team that examined 1,000 lumbar spine (lower back) MRI requests and 1,000 head MRI requests.
Findings from the newly-published study found that while head MRIs ordered for patients with headaches are appropriate 83 per cent of the time, more than half of lower-back MRIs ordered are either inappropriate or of questionable value for patients.
In Alberta, about 165,000 MRIs are performed a year with 25,000 of those being lower-back MRIs.
A local neuroradiologist and lead author of the study says the results show lower-back MRIs need to be reined in.
“Over half the MRI requests for lumbar spine (lower back) were either inappropriate or of uncertain value and by inappropriate it’s unlikely to be a benefit to the patient or patient care,” said Dr. Derek Emery with the Faculty of Medicine and Dentistry.
“We can use this data to look at our system and find a way to weed out those cases which are not necessary.”
Access to MRIs limited
Researchers say the findings are important because in some parts of Canada, MRI tests for the lower back account for about one-third of all MRI requests, while wait times for MRIs are long and patient access is limited in all areas of the country.
“MRI in Alberta is quite a limited resource,” Emery said.
“There are a lot of patients in Alberta who would benefit from an MRI that are not getting them because we don’t have the access so if we can eliminate some of the unnecessary MRIs that will give us more capacity for patients who really need it and would benefit.”
Research found that family doctors were also more likely to order the unnecessary tests compared to other specialists.
Emery says they’re looking to see if a tool could be developed to provide doctors with more information on whether ordering an MRI would be beneficial for patients.
“We really need to feed back to the people ordering MRIs, give them better data, better tools, better education in terms of when an MRI will help that patient,” Emery said.
"We have limited capacity for MRI and we have to use it wisely. If we can eliminate some of the unnecessary studies we'll have more room to do studies that will be more beneficial."
This is the first study of its kind where researchers have taken an in-depth look into MRI requests.
Back MRIs are usually done to determine the cause of back pain, while head MRIs examined in the study were done to identify cause of headaches.
Researchers from the University of Alberta, University of Calgary, University of Ottawa and University of Toronto, looked at requests for MRI imaging of the lumbar spine and head at the University of Alberta Hospital and The Ottawa Hospital.
The study was published in Jama Internal Medicine on Monday.
Research was funded by the Canadian Institutes of Health Research.
With files from Carmen Leibel