reviews, commentaries and duplications Jarvik 2002 search from 73 studies CT MRI myelography sensitivity Patients with LBP in the No Jan 1966-Sep Poor quality N=not MRI bone expert panel specificity primary setting due to: 2001 reported scintigraphy consensus X-ray positive LR herniated disc excluded animal Setting of biopsy negative spinal stenosis studies, included imaging LR spinal fracture paediatric studies not (planar spinal malignancy studies, case reported but imaging, reports, review spinal infection review SPECT) articles, AS focused on editorials, and imaging non-English modalities articles used in the primary care setting only Abbreviations: AS, ankylosing spondylitis; CPG, clinical practice guideline; CT, computed tomography; LBP, low back pain; LR, likelihood ratio; MRI, magnetic resonance imaging; SPECT, single-photon emission computerised tomography; TNF, tumour necrosis factor. a See Appendix 6 for quality assessment forms. Table 035 Characteristics of subsequent published primary studies of diagnostic accuracy of imaging for low back pain Number of Patient population Ref ID and Intervention/ Reference Outcome patients, Setting Comparators Qualitya index test standard measures Inclusions/Exclusions and Country N/A Moranjkic Prospective MRI surgical findings sensitivity Patients with: 2011 study of 70 CT specificity radicular pain and evidence of nerve root irritation with patients (30 Fair quality a positive nerve root tension sign or a corresponding operated on due neurologic deficit
reviews, commentaries and duplications Jarvik 2002 Poor quality search from Jan 1966-Sep 2001 excluded animal studies, paediatric studies, case reports, review articles, editorials, and non-English articles 73 studies N=not reported Setting of included studies not reported but review focused on imaging modalities used in the primary care setting only Patients with LBP in the primary setting due to: herniated disc spinal stenosis spinal fracture spinal malignancy spinal infection AS CT MRI X-ray imaging (planar imaging, SPECT) MRI bone scintigraphy myelography expert panel consensus biopsy sensitivity specificity positive LR negative LR No Abbreviations: AS, ankylosing spondylitis; CPG, clinical practice guideline; CT, computed tomography; LBP, low back pain; LR, likelihood ratio; MRI, magnetic resonance imaging; SPECT, single-photon emission computerised tomography; TNF, tumour necrosis factor. a See Appendix 6 for quality assessment forms. Table 035 Characteristics of subsequent published primary studies of diagnostic accuracy of imaging for low back pain Ref ID and Qualitya Number of patients, Setting and Country Patient population Inclusions/Exclusions Intervention/ index test Comparators Reference standard Outcome measures Moranjkic 2011 Fair quality Prospective study of 70 patients (30 operated on due Patients with: radicular pain and evidence of nerve root irritation with a positive nerve root tension sign or a corresponding neurologic deficit MRI CT N/A surgical findings sensitivity specificity