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Have Referral Patterns for Vertebroplasty Changed since Publication of the Placebo-Controlled Trials?

Have Referral Patterns for Vertebroplasty Changed since Publication of the Placebo-Controlled... BACKGROUND AND PURPOSE: Our aim was to determine whether referral patterns and rates of vertebroplasties at the Mayo Clinic have changed after the publication of the INVEST and the Australian Trial. In August of 2009, we performed a retrospective review of patients undergoing vertebroplasties and those patients who were referred for but did not receive vertebroplasties before and after the recently published placebo-controlled vertebroplasty trials. MATERIALS AND METHODS: After approval by our local institutional review board, we retrospectively evaluated all patients referred for vertebroplasty between January 5, 2004, and June 2, 2010. We catalogued age, sex, number of treated vertebrae, physician referring the patient for vertebroplasty, and the referring department. We calculated the mean number of referrals per month before and after August 2009, which was the month of publication for both trials. We also calculated rates for specific referring physician types. RESULTS: During the full study, 1188 patients were referred, of whom 807 underwent treatment at 1378 levels for a total of 943 separate vertebroplasty procedures. The mean number of vertebroplasty referrals per month has dropped significantly from 18.9 ± 5.3 (95% CI, 17.7–20.2) before publication to 11.3 ± 3.1 (95% CI, 9.1–13.5) referrals per month after publication ( P = .0001). Before publication, 67.3 ± 14.0% (95% CI, 64.0%–70.7%) of patients referred for vertebroplasty underwent vertebroplasty, compared with 76.0 ± 14.9% (95% CI, 65.4%–86.6%) after publication ( P = .11). CONCLUSIONS: The number of vertebroplasty referrals at our center has decreased significantly since the publication of INVEST and the Australian Trial, yet we continue to offer the procedure to a high proportion of referred patients. Abbreviations CI confidence interval INVEST INvestigational Vertebroplasty Efficacy and Safety Trial PMR Physical Medicine and Rehabilitation http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Have Referral Patterns for Vertebroplasty Changed since Publication of the Placebo-Controlled Trials?

American Journal of Neuroradiology , Volume 32 (4): 647 – Apr 1, 2011

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2011 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A2371
pmid
21349971
Publisher site
See Article on Publisher Site

Abstract

BACKGROUND AND PURPOSE: Our aim was to determine whether referral patterns and rates of vertebroplasties at the Mayo Clinic have changed after the publication of the INVEST and the Australian Trial. In August of 2009, we performed a retrospective review of patients undergoing vertebroplasties and those patients who were referred for but did not receive vertebroplasties before and after the recently published placebo-controlled vertebroplasty trials. MATERIALS AND METHODS: After approval by our local institutional review board, we retrospectively evaluated all patients referred for vertebroplasty between January 5, 2004, and June 2, 2010. We catalogued age, sex, number of treated vertebrae, physician referring the patient for vertebroplasty, and the referring department. We calculated the mean number of referrals per month before and after August 2009, which was the month of publication for both trials. We also calculated rates for specific referring physician types. RESULTS: During the full study, 1188 patients were referred, of whom 807 underwent treatment at 1378 levels for a total of 943 separate vertebroplasty procedures. The mean number of vertebroplasty referrals per month has dropped significantly from 18.9 ± 5.3 (95% CI, 17.7–20.2) before publication to 11.3 ± 3.1 (95% CI, 9.1–13.5) referrals per month after publication ( P = .0001). Before publication, 67.3 ± 14.0% (95% CI, 64.0%–70.7%) of patients referred for vertebroplasty underwent vertebroplasty, compared with 76.0 ± 14.9% (95% CI, 65.4%–86.6%) after publication ( P = .11). CONCLUSIONS: The number of vertebroplasty referrals at our center has decreased significantly since the publication of INVEST and the Australian Trial, yet we continue to offer the procedure to a high proportion of referred patients. Abbreviations CI confidence interval INVEST INvestigational Vertebroplasty Efficacy and Safety Trial PMR Physical Medicine and Rehabilitation

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: Apr 1, 2011

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