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. 2022 Apr 21;22(1):73.
doi: 10.1186/s12880-022-00798-2.

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

Elin Kjelle  1 , Eivind Richter Andersen  2 , Arne Magnus Krokeide  2 , Lesley J J Soril  3 , Leti van Bodegom-Vos  4 , Fiona M Clement  3 , Bjørn Morten Hofmann  2   5
Affiliations

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

Elin Kjelle et al. BMC Med Imaging. .

Abstract

Background: Inappropriate and wasteful use of health care resources is a common problem, constituting 10-34% of health services spending in the western world. Even though diagnostic imaging is vital for identifying correct diagnoses and administrating the right treatment, low-value imaging-in which the diagnostic test confers little to no clinical benefit-is common and contributes to inappropriate and wasteful use of health care resources. There is a lack of knowledge on the types and extent of low-value imaging. Accordingly, the objective of this study was to identify, characterize, and quantify the extent of low-value diagnostic imaging examinations for adults and children.

Methods: A scoping review of the published literature was performed. Medline-Ovid, Embase-Ovid, Scopus, and Cochrane Library were searched for studies published from 2010 to September 2020. The search strategy was built from medical subject headings (Mesh) for Diagnostic imaging/Radiology OR Health service misuse/Medical overuse OR Procedures and Techniques Utilization/Facilities and Services Utilization. Articles in English, German, Dutch, Swedish, Danish, or Norwegian were included.

Results: A total of 39,986 records were identified and, of these, 370 studies were included in the final synthesis. Eighty-four low-value imaging examinations were identified. Imaging of atraumatic pain, routine imaging in minor head injury, trauma, thrombosis, urolithiasis, after thoracic interventions, fracture follow-up and cancer staging/follow-up were the most frequently identified low-value imaging examinations. The proportion of low-value imaging varied between 2 and 100% inappropriate or unnecessary examinations.

Conclusions: A comprehensive list of identified low-value radiological examinations for both adults and children are presented. Future research should focus on reasons for low-value imaging utilization and interventions to reduce the use of low-value imaging internationally.

Systematic review registration: PROSPERO: CRD42020208072.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the selection process of articles
Fig. 2
Fig. 2
Overview of proportion of low-value examinations in different patient complains/diagnosis. The blue bar represents the minimum rate and the combined blue and orange bar represents the maximum inappropriate rate
See this image and copyright information in PMC

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