Armaghane Danesh Bimonthly Journal (May 2013)
Developing Appropriateness criteria for MRI of Low Back Pain(LBP) using Rand Appropriateness Method (RAM)
Abstract
Abstract Background & aim: MRI is a new and expensive diagnostic technology which has been increasingly used globally. This aim of study was to determining the administration of MRI for the Lumbar vertebrae using the appropriate RAND Method. Methods: This qualitative study was based on consensus. The population study included 9 professionals involved in prescribing the procedure based on Rand. Two criteria were identified: Valid clinical guidelines and expert opinion. Scoring criteria were the numbers 1 to 9. Numbers in the range of 1 to 3 unfit, 4 to 6, unreliable, and 7 to 9, placed in an appropriate range. An agreement was done when 7 specialists agreed marked the same range. Results: 97 scenarios were selected for the lumbar spine MRI in the extracting phase. 18 other scenarios were added by panel members. Finally, a total of 115 scenarios were identified. After implementing two rounds, the scenarios were categorized into three ranges. Sixty eight (%59.1) of the scenarios were considered as appropriate, 44(%38.2) as uncertain, and 3(%2.6) as inappropriate. Conclusion: A developed scenario in this project for MRI lumbar vertebrae treated with Guide is perfect for specialists. It is recommended that insurance companies and other institutions use this as a benchmark for the payment of MRI lumbar vertebrae fees. RAND appropriateness Method is useful for identifying stakeholder views in settings with limited resources. Key words: Lumbar Spine, Low Back Pain, RAND Appropriateness Method
