Seattle Lumbar Imaging Project (SLIP). Executive Summary;Rept. for 30 Sep 98-31 Dec 02

摘要

The Seattle Lumbar Imaging Project (SLIP was a multi-center randomized trial that evaluated the consequences of substituting a rapid MRI for radiographs as the initial imaging for primary care patients with low back pain. Our primary outcome was the 12- month modified Roland score, a back-specific disability scale. After controlling for baseline modified Roland score and study site, there was no significant difference in our primary outcome between the radiography group (9.02, 95%Cl= 7.78-10.3) and the MR group (9.83, 95% CI=8.55-11.1). Reassurance from the MR was consistently rated higher than for the radiograph. Patients randomized to radiography had more conventional MRs, physical therapy, acupuncture, massage, osteopathic and chiropractic manipulation in the year following randomization. Patients randomized to rapid MR had more subsequent radiographs of the lumbar spine and more specialist consultations. Six percent of patients randomized to rapid MR had lumbar spine surgery within one year compared to two percent in the radiography group. The mean cost of care of was higher in patients randomized to MR ($2121) vs. $1651), but this was not statistically significant.