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

• Published in: BMC medical imaging Vol. 22; no. 1; pp. 73 - 28
• Main Authors: Kjelle, Elin, Andersen, Eivind Richter, Krokeide, Arne Magnus, Soril, Lesley J. J., van Bodegom-Vos, Leti, Clement, Fiona M., Hofmann, Bjørn Morten
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.04.2022; BioMed Central; BMC
• Subjects: Adult; Adults; Breast cancer; Child; Children; Clinical trials; Design; Diagnostic Imaging; Diagnostic systems; Head injuries; Health care; Health services; Humans; Literature reviews; Lithiasis; Magnetic resonance imaging; Medical diagnosis; Medical imaging; Medical Subject Headings-MeSH; Pain; Patients; Pediatrics; Quality control; Radiology; Reviews; Thorax; Thromboembolism; Thrombosis; Trauma; Urolithiasis; Utilization; X-rays
• ISSN: 1471-2342; 1471-2342
• DOI: 10.1186/s12880-022-00798-2

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. 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. 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. 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. PROSPERO: CRD42020208072.