Quality Insights: Clinical Quality in Primary Care

Adult Diagnostic and Preventive Care:
Using Imaging Tests for Lower Back Pain Only When Appropriate

Healthcare quality measure: This measure looks at the percent of adult patients (18 to 50 years old) who get imaging tests within 28 days after being diagnosed with lower back pain. Imaging tests include X-rays, MRIs, and CT-scans. A higher score means that more patients did not get imaging tests during this time – which is good.

Reasons for this measure: Back problems are very common. In fact, 2 in 3 adults in the U.S. have back pain sometime in their lives. It is one of the top ten reasons that people go to see their doctor, and is the most common and expensive reason for going on work disability in the US. Studies show that most patients with lower back pain get better without a lot of medical treatment. Imaging tests, surgery, or other costly treatments often do not help “short-term” back pain (that goes away within four weeks).

Click on a column heading to put the results below in order.

Medical Group
Comparison
Rate
Rating
Benchmarks:
   Nat'l Average
   90th Percentile
   MA Rate
National Average
National 90th Percentile
MA Rate

74.2%
82.0%
78.4%
 
Tufts Medical Center Physicians
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75.2%

above one benchmarkabove one benchmarkabove one benchmarkabove one benchmark

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MA Rate (78.4%)

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Explanation of the Star Ratings...

  • above three benchmarksabove three benchmarksabove three benchmarksabove three benchmarks Four stars means the rate is above three benchmarks
  • above two benchmarksabove two benchmarksabove two benchmarksabove two benchmarks Three stars means the rate is above two benchmarks
  • above one benchmarkabove one benchmarkabove one benchmarkabove one benchmark Two stars means the rate is above one benchmark
  • not above benchmarksnot above benchmarksnot above benchmarksnot above benchmarks One star means the rate is not above benchmarks
  • no data available MHQP has too little data to report on this measure. This can happen when the patients or illnesses a medical group cares for are not part of this report.

The three benchmarks used for comparison are:

  • The MHQP Massachusetts Statewide Rate
  • The National 90th Percentile
  • The National Average

Click here to view the MHQP Massachusetts Statewide Rates
and National benchmarks.

For more information on benchmarks, please see Questions & Answers.

Ways your doctor can help...

  • Assess your pain. Your doctor may do an exam of your lower back to find out why you are having this pain. He or she may ask if you have had back pain before and, if so, what helped. Your doctor may ask questions to find out if your back pain is related to another health concern (such as a recent trauma or unexplained high fever) and may order X-rays at this point.
  • Suggest ways to help manage your pain. This may include ice, mild pain medication (such as Ibuprofen, the generic version of Motrin or Advil; or Acetaminophen, the generic version of Tylenol), rest, and mild activity such as walking. Most people feel better when they manage their pain with these methods.
  • Order imaging tests only if your lower back pain is long-term (lasts four weeks or more). An X-ray, MRI, or CT-scan at that time may help your doctor figure out the cause of your pain and ways to treat it.

Ways you can help...

  • Do what your doctor suggests to manage back pain. This may include ice, mild pain medication (such as Ibuprofen, the generic version of Motrin or Advil; or Acetaminophen, the generic version of Tylenol), and rest.
  • Be active and move as much as you can. Studies show that this often helps reduce back pain and stiffness.
  • Eat a healthy diet. This includes foods with calcium and vitamin D (such as yogurt and other dairy products, and calcium rich vegetables like broccoli). A healthy diet can help keep bones strong and prevent osteoporosis (a disease that weakens bones which may lead to fractures and pain).
  • Stay a healthy weight. There is extra stress and strain on your back when you are over-weight. Talk with your doctor about whether you need to lose weight and ask about safe exercise choices.

Ways to learn more...

 

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