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Inappropriate Use of Lumbar Magnetic Resonance Imaging: Limitations and Potential Solutions—Reply

Inappropriate Use of Lumbar Magnetic Resonance Imaging: Limitations and Potential Solutions—Reply Letters stable injury fatality rate over the decade; however, this is an 4. The study was conducted in 2 hospitals. Generalizability of open question requiring further study. results is unknown. Westphal addresses the use of fatality rates in the Pois- 5. The authors suggest that appropriateness should be as- son regression models to determine the relationship sessed and compared across other health services. Are- between firearm legislation and firearm-related fatalities. cent study in 12 Spanish public and private hospitals across The regression models we used in our study accurately 6 regions shows that at least 11.9% of the lumbar MRI in rou- evaluated this relationship ; however, we repeated tine practice are inappropriate; this proportion increases to the analysis using Poisson models with counts of deaths 17.2% in private care and to 27.8% among patients without rather than rates, adjusted for population. Using this meth- pain referred down to the leg. Differences in results may odology in our previous multivariable model, we derive from limitations described in points 1 to 3 and from found a similar effect of legislation (incident rate ratio for differences in methods, which in the Spanish study were de- suicide, 0.41 in the fourth compared http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Inappropriate Use of Lumbar Magnetic Resonance Imaging: Limitations and Potential Solutions—Reply

Emery, Derek J.; Feasby, Thomas E.
JAMA Internal Medicine , Volume 173 (21) – Nov 25, 2013
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References (4)

Publisher
American Medical Association
Copyright
Copyright 2013 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2013.9956
pmid
24276055
Publisher site
See Article on Publisher Site

Abstract

Letters stable injury fatality rate over the decade; however, this is an 4. The study was conducted in 2 hospitals. Generalizability of open question requiring further study. results is unknown. Westphal addresses the use of fatality rates in the Pois- 5. The authors suggest that appropriateness should be as- son regression models to determine the relationship sessed and compared across other health services. Are- between firearm legislation and firearm-related fatalities. cent study in 12 Spanish public and private hospitals across The regression models we used in our study accurately 6 regions shows that at least 11.9% of the lumbar MRI in rou- evaluated this relationship ; however, we repeated tine practice are inappropriate; this proportion increases to the analysis using Poisson models with counts of deaths 17.2% in private care and to 27.8% among patients without rather than rates, adjusted for population. Using this meth- pain referred down to the leg. Differences in results may odology in our previous multivariable model, we derive from limitations described in points 1 to 3 and from found a similar effect of legislation (incident rate ratio for differences in methods, which in the Spanish study were de- suicide, 0.41 in the fourth compared

Journal

JAMA Internal Medicine – American Medical Association

Published: Nov 25, 2013

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