Lorraine Ash MD, Presenter: Nothing to Disclose

Michael Terrence Modic MD, Abstract Co-Author: Nothing to Disclose

Jeffrey S. Ross MD, Abstract Co-Author: Nothing to Disclose

Nancy A. Obuchowski PhD, Abstract Co-Author: Nothing to Disclose

Paul N. Grooff MD, Abstract Co-Author: Nothing to Disclose

Michael N. Brant-Zawadzki MD, Abstract Co-Author: Nothing to Disclose

Prospective randomized study to assess the effect of knowledge of diagnostic findings by patients and physicians on clinical outcome.

246 patients with acute-onset (<3 weeks) of LBP and/or radiculopathy (150 LBP and 96 radiculopathy patients) were recruited. Patients were randomized using a stratified block design with equal allocation, to either the early information arm (i.e. MR results provided within 48 hours) or the blinded arm (i.e. both patient and physician blinded to MR results). After the initial MR, patients followed six weeks of conservative management. Roland function, visual pain analog, absenteeism, SF-36 Health Status Survey, SES, and FAQ questionnaires were completed at presentation, 2, 4, 6, and 8 weeks, and 6, 12, and 24 months. Improvement of Roland score by 50% or more and patient satisfaction assessed by Cherkin symptom satisfaction measure was considered a positive outcome.

Clinical outcome at six weeks was similar for unblinded and blinded patients. Self-efficacy, fear-avoidance beliefs, and the SF-36 subscales were similar over time for blinded and unblinded patients, except for the general health subscale on the SF-36. General health of the blinded group improved more than for the unblinded group (p=0.008).

Patient knowledge of the imaging findings do not alter outcome and are associated with a lesser sense of well being.

Ash, L, Modic, M, Ross, J, Obuchowski, N, Grooff, P, Brant-Zawadzki, M, Effect of Diagnostic Information per se on Patient Outcomes in Acute Radiculopathy and Low Back Pain.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409053.html