Table 1:

Characteristics of studies included in the systematic review

StudyInterventionControlClinical settingPatientsOutcome measure
Cluster RCT
Eccles et al.7

  1. Audit and feedback

  2. Reminders

  3. Both

Guideline dissemination243 general practicesAll patients with any clinical presentation (no. not reported)Imaging rate per 1 000 patients
French et al.18Practitioner education*Guideline dissemination92 general practices152 942 (77 716 intervention, 75 226 control) with any clinical presentationImaging rate per 1 000 patients
Dey et al.19Practitioner education* with guidelines on secondary care referralNo intervention23 general practices2 187 (1 049 intervention, 1 138 control) with acute low-back painImaging rate (%) among patients with low-back pain
Schectman et al.20

  1. Practitioner education with audit and feedback

  2. Patient education

  3. Both

No intervention14 general practices4 066 (2 020 baseline year, 2 046 study year) with acute low-back painImaging rate (%) among patients with low-back pain
Kerry et al.21Guideline dissemination with audit and feedbackNo intervention69 general practicesAll patients with any clinical presentation (no. not reported)No. of imaging referrals
Interrupted time series
Matowe et al.17Guideline disseminationNA87 general practicesAll patients with any clinical presentation (no. not reported)No. of imaging referrals
Baker et al.24Clinical decision support†NAHospitalAll patients with any clinical presentation (no. not reported)No. of imaging referrals

  • Note: NA = not applicable, RCT = randomized controlled trial.

  • ↵* Face-to-face workshop that included guideline dissemination and implementation strategies.

  • ↵† Introduction of new imaging referral form, requiring categorization of low-back pain for appropriate referral.