Patient and public beliefs about the role of imaging in the management of non-specific low back pain: a scoping review.

ABSTRACT

BACKGROUND OR CONTEXT Routine imaging for non-specific low back pain is advised against in guidelines yet imaging continues to occur. Patient and public beliefs regarding imaging may be a driving factor contributing to this. OBJECTIVES: To review the current evidence in relation to patient and public beliefs regarding imaging for low back pain. DATA SOURCES A systematic scoping review was conducted in databases Medline, Embase, Cinahl, Psyc info (inception - Jan 2018). STUDY SELECTION Any method of study including beliefs of adults about imaging for non-specific low back pain. DATA EXTRACTION AND DATA SYNTHESIS: Descriptive data was extracted and patient and public beliefs about imaging for low back pain was analysed using conventional qualitative content analysis. RESULTS: 12 studies from an initial search finding of 1135 were analysed. 3 main themes emerged; (1) The Desire for imaging; (2) Influences on patient desire for imaging including (a) clinical presentation, (b) past experience and (c)relationships with care professionals and (3) Negative consequences of imaging. LIMITATIONS: Few qualitative studies were found, all studies were in English language, the majority of studies were older than 2003. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: There is little available evidence on patient and public beliefs about imaging but what evidence there is suggests that imaging is seen as positive in the management of low back pain and patient desire for a diagnosis is a big driver of this. There is also a suggestion that these beliefs may still be being influenced by health care professionals.