Effect of information format on intentions and beliefs regarding diagnostic imaging for non-specific low back pain: A randomised controlled trial in members of the public

Sweekriti Sharma*, Adrian C. Traeger, Mary O'Keeffe, Tessa Copp, Alexandra Freeman, Tammy Hoffmann, Chris G. Maher

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: To evaluate the effects of information format on intentions to request diagnostic imaging for non-specific low back pain in members of the public. 

Methods: We performed a three arm, 1:1:1, superiority randomised trial on members of the public. Participants were randomised to one of the three groups: a Standard Care Leaflet group (standard information on low back pain), a Neutral Leaflet group (balanced information on the benefits and harms of imaging) and a Nudge Leaflet group (with behavioural cues to emphasise the harms of unnecessary imaging). Our primary outcome was intention to request imaging for low back pain. 

Results: 418 participants were randomised. After reading the leaflet, intention to request imaging (measured on an 11-point scale (0 = definitely would not request to 10 = definitely would request) was lower in the Nudge Leaflet group (mean = 4.6, SD = 3.4) compared with the Standard Care Leaflet group (mean = 5.3, SD = 3.3) and the Neutral Leaflet group (mean = 5.3, SD = 3.0) (adjusted mean difference between Nudge and Neutral, −1.0 points, 95%CI −1.6 to −0.4). 

Conclusion: Framing information to emphasise potential harms from overdiagnosis reduced intention to request diagnostic imaging for low back pain. 

Practice implications: Nudge leaflets could help clinicians manage patient pressure for unnecessary tests.

Original languageEnglish
JournalPatient Education and Counseling
DOIs
Publication statusE-pub ahead of print - 19 Aug 2020

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