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37 Reducing overuse of low value imaging: a systematic review
  1. Tessa Rietbergen,
  2. Sietse Terpstra,
  3. Leti van Bodegom-Vos
  1. Department of Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands


Objectives Low value imaging provides little or no benefit to the patient, may cause harm, and waste resources. To reduce low value imaging, we need to know how to change clinical practice Therefore, the aim of this systematic review was to summarize the overall evidence about effective strategies aiming to reduce low value imaging.

Method We searched PubMed, Embase, ISI Web of Science, Cochrane Central Register of Controlled Trials, Emcare, Academic Search Premier and ScienceDirect for studies reporting the effectiveness of interventions aiming to reduce unnecessary imaging. Only studies that were written in English were included. There were no restrictions for publication date (inception to 11 April 2019). Reference lists and citations of the included studies are still being searched. Studies that were included in the review had the following designs: randomized controlled trial, cluster randomized trials, quasi-randomized controlled trial, non-randomized controlled trial, controlled before and after study, interrupted time series study or uncontrolled before-after. Case studies of individual patients, letters and editorials were excluded.

Results Of the 1045 screened so far, 42 studies met the inclusion criteria. Some examples of low value imaging in the included studies were chest X-rays, MRIs, CT brain scans, pelvic ultrasound. Following the Effective Practice and Organisation of Care (EPOC) taxonomy, most of the interventions could be divided in the categories structural interventions, educational meetings, educational materials, educational outreach visits, and audit and feedback. Additional results regarding effectiveness of the strategies will be available in autumn 2019.

Conclusions Final data (expected in autumn 2019) have to be awaited before conclusions can be drawn.

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