Choosing wisely: Imaging for lower back pain

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New Brunswick Institute for Research, Data and Training


As part of a global movement that began in the United States in 2012, Choosing Wisely Canada was launched in 2014 to help reduce unnecessary tests and treatments in healthcare. One of its recommendations is to not do imaging for lower back pain unless ‘red flags’ – or conditions that warrant diagnostic imaging – are present. In 2015, the Canadian Medical Imaging Inventory indicated that New Brunswick (NB) had the third-highest number of average CTs (computed tomography scans) per 1,000 population. In 2020, a revised report suggested NB had the highest number in the entire country. To date, there has been no detailed breakdown of the diagnostic imaging performed in NB to inform of past trends or advise on future directions; the Choosing Wisely New Brunswick steering committee therefore prioritized the investigation of accessible health data. This study aims to address this issue by linking lumbar spine imaging data with population demographics data at the New Brunswick Institute for Research, Data and Training to look for variations in lumbar spine imaging patterns in NB between 2012 and 2019. We investigate regional volumes and types of imaging and identify the volume of lower back pain imaging that aligns with indicators of red flag conditions.