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1、Appendix2–MeasureDefinitionsChoosingWisely:PrevalenceandCorrelatesofLow-ValueHealthCareServicesintheUnitedStatesCarrieHColla,NancyEMorden,ThomasDSequist,WilliamLSchpero,MeredithBRosenthalTableofContentsMethodsforMeasuringLow-ValueDiagnosticServicesBackPainImaging(pp.2)Benig
2、nProstaticHyperplasiaImaging(pp.5)CardiacScreening(pp.7)CervicalCancerScreening(pp.73)Dual-EnergyX-rayAbsorptiometry(DXA)Testing(pp.75)PreoperativeCardiacTesting(cataractsurgery)(pp.77)PreoperativeCardiacTesting(non-cardiacsurgery)(pp.171)VitaminDScreening(pp.175)Methodsfor
3、MeasuringLow-ValueTreatmentsAntipsychoticsinDementiaPatients(pp.178)FeedingTubesinDementiaPatients(pp.181)OpioidsforMigraines(pp.184)AbbreviationsBETOS:Berenson-EggersTypeofServiceCPT:CurrentProceduralTerminologyCCS:ClinicalClassificationsSoftwareHCC:HierarchicalConditionCa
4、tegoriesICD-9:InternationalStatisticalClassificationofDiseases,NinthEdition185Don'tdoimagingforlowbackpainwhennoredflagsarepresentChoosingWiselyGuidelinesAmericanAcademyofFamilyPhysiciansDon’tdoimagingforlowbackpainwithinthefirstsixweeks,unlessredflagsarepresent.Redflagsinc
5、lude,butarenotlimitedto,severeorprogressiveneurologicaldeficitsorwhenseriousunderlyingconditionssuchasosteomyelitisaresuspected.Imagingofthelowerspinebeforesixweeksdoesnotimproveoutcomes,butdoesincreasecosts.Lowbackpainisthefifthmostcommonreasonforallphysicianvisits.America
6、nCollegeofPhysiciansDon’tobtainimagingstudiesinpatientswithnon-specificlowbackpain.Inpatientswithbackpainthatcannotbeattributedtoaspecificdiseaseorspinalabnormalityfollowingahistoryandphysicalexamination(e.g.,non-specificlowbackpain),imagingwithplainradiography,computedtomo
7、graphy(CT)scan,ormagneticresonanceimaging(MRI)doesnotimprovepatientoutcomes.NorthAmericanSpineSocietyDon’trecommendadvancedimaging(e.g.,MRI)ofthespinewithinthefirstsixweeksinpatientswithnon-specificacutelowbackpainintheabsenceofredflags.Intheabsenceofredflags,advancedimagin
8、gwithinthefirstsixweekshasnotbeenfoundtoimproveoutcomes,butdoesincreasecosts.Redfl
