Editorial Type: ORIGINAL ARTICLES
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Online Publication Date: 01 Apr 2010

Diagnostic Imaging Guidelines Implementation Study for Spinal Disorders: A Randomized Trial with Postal Follow-ups*

DC, MSc,
PhD, and
DC, RN, MMedEd
Article Category: Research Article
Page Range: 2 – 18
DOI: 10.7899/1042-5055-24.1.2
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Purpose: Implementation strategies of imaging guidelines can assist in reducing the number of radiographic examinations. This study aimed to compare the perceived need for diagnostic imaging before and after an educational intervention strategy. Methods: One hundred sixty Swiss chiropractors attending a conference were randomized to either receive a radiology workshop, reviewing appropriate indications for diagnostic imaging for adult spine disorders (n = 80), or be in a control group (CG). One group of 40 individuals dropped out from the CG due to logistic reasons. Participants in the intervention group were randomly assigned to three subgroups to evaluate the effect of an online reminder at midpoint. All participants underwent a pretest and a final test at 14–16 weeks. A posttest was administered to two subgroups at 8–10 weeks. Results: There was no difference between baseline scores, and overall scores for the pretest and the final tests for all four groups were not significantly different. However, the subgroup provided with access to a reminder performed significantly better than the subgroup with whom they were compared (F = 4.486; df = 1 and 30; p = .043). Guideline adherence was 50.5% (95% CI, 39.1–61.8) for the intervention group and 43.7% (95% CI, 23.7–63.6) for the CG at baseline. Adherence at follow-up was lower, but mean group differences remained insignificant. Conclusions: Online access to specific recommendations while making a clinical decision may favorably influence the intention to either order or not order imaging studies. However, a didactic presentation alone did not appear to change the perception for the need of diagnostic imaging studies.

Copyright: © 2010 Association of Chiropractic Colleges 2010

Contributor Notes

About the Authors

André E. Bussières is with the Chiropractic Department, Université du Québec à Trois-Rivières and with the PhD Population Health Program, University of Ottawa. Louis Laurencelle is with Département des Sciences de l'Activité Physique, Université du Québec à Trois-Rivières. Cynthia Peterson is with the Swiss Academy for Chiropractic.

Address correspondence to André Bussières, Département Chiropratique, Université du Québec à Trois-Rivières, C.P. 500, Trois-Rivières, Québec, Canada G9A 5H7 (e-mail: andre.bussières@uqtr.ca).
Received: 04 Jun 2009
Accepted: 29 Sept 2009
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