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Low Back Pain: Influence of Early MR Imaging or CT on Treatment and Outcome—Multicenter Randomized Trial¹

¹ From Depts of Radiology (F.J.G., M.G.C.G.), Health Services Research Unit (A.M.G., M.G.C.G., L.D.V., M.K.C.), Health Economics Research Unit (L.D.V.), Public Health (N.W.S.), and Orthopaedic Surgery (D.J.K., D.W.), University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, Scotland. Members of the Scottish Back Trial Group and their affiliations are listed at the end of this article. Received Jun 12, 2003; revision requested Aug 13; final revision received Oct 31; accepted Nov 25. Supported by NHS Research & Development Health Technology Assessment Programme. Health Services Research Unit and Health Economics Research Unit supported by Chief Scientist Office, Scottish Executive Health Dept. Address correspondence to F.J.G. (e-mail: f.j.gilbert@abdn.ac.uk).

View larger version (59K): [in a new window]   Figure 1. Diagram shows progress of participants through trial.

View larger version (25K): [in a new window]   Figure 2. Graph shows subgroup analysis of ALBP score at 24 months after trial entry, with adjusted difference in ALBP score and 99% CIs for subgroups and 95% CIs for overall trial result. This analysis indicates that subgroup data were generally consistent with overall trial results (dotted vertical line), that is, greater improvement in health was observed in the early group. Solid vertical line denotes no difference between the groups.

View larger version (25K): [in a new window]   Figure 3. Graph shows cost-effectiveness acceptability curve. Image illustrates the impact on the incremental cost per QALY of changes in the cost of imaging. As the cost of imaging increases, the likelihood that an early imaging strategy is cost-effective decreases.