Watchful waiting as a strategy to reduce low-value spinal imaging: study protocol for a randomized trial
نویسندگان
چکیده
Abstract Background Patients with acute low back pain frequently request diagnostic imaging, and clinicians feel pressure to acquiesce such requests sustain patient trust satisfaction. Spinal imaging in patients poses risks from evaluation of false-positive findings, labeling anxiety, unnecessary treatment (including spinal surgery). Watchful waiting advice has been an effective strategy reduce some low-value treatments, evidence suggests a watchful approach would be acceptable many requesting tests. Methods We will use key informant interviews focus groups primary care refine theory-informed standardized patient-based intervention designed teach how advise when for pain. test the effectiveness randomized clinical trial. recruit 8–10 urgent clinics (~ 55 clinicians) Sacramento, CA; 1:1 control groups. Over 3- 6-month period, group receive 3 visits instructors (SPIs) portraying pain; SPIs instruct three-step model emphasizing establishing trust, empathic communication, negotiation approach. Control physicians no intervention. The outcome is post-intervention rate among actual seen by adjusted during baseline period. Secondary outcomes are targeted communication techniques follow-up visit SP, clinician self-reported patients, rates other musculoskeletal syndromes (to generalization effects beyond pain), satisfaction physicians. Discussion This trial determine whether can help develop skill negotiating pain, thereby reducing imaging. also examine possibility that generalize Trial registration ClinicalTrials.gov NCT 04255199 . Registered on January 20, 2020
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ژورنال
عنوان ژورنال: Trials
سال: 2021
ISSN: ['1745-6215']
DOI: https://doi.org/10.1186/s13063-021-05106-x