School of Medicine

Despite evidence--‐based literature and society guidelines regarding appropriateness of MR imaging in the setting of low back pain, there continues to be a high utilization of MR scans of the lumbar spine in the emergency department setting. An IRB--‐ approved 2 year retrospective review was performed of the imaging and electronic health record at a regional academic medical center encompassing 2 EDs to compare demographic, exam and “soft” factors that may explain pressure or expectation for MR imaging in the ED setting. Our goal is to create a novel model to identify the qualitative factors that effect physician imaging ordering behavior in the ED and extrapolate them into quantifiable data points that can be objectively compared. The results of this project will help us better understand the nuances of the physician--‐patient relationship in the ED and allow us to build imaging protocols that reflect the complexity of care provided in the emergency department setting.