{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:55:21Z","timestamp":1788857721075,"version":"build-2803163510"},"reference-count":43,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,1,23]],"date-time":"2019-01-23T00:00:00Z","timestamp":1548201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Institute for Health Care Management Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"DOI":"10.1093\/intqhc\/mzy248","type":"journal-article","created":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T12:08:19Z","timestamp":1545221299000},"source":"Crossref","is-referenced-by-count":12,"title":["Magnitude and financial implications of inappropriate diagnostic imaging for three common clinical conditions"],"prefix":"10.1093","author":[{"given":"Stephen","family":"Flaherty","sequence":"first","affiliation":[{"name":"Bouve College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston MA, USA"},{"name":"Northeastern University Center for Health Policy and Healthcare Research, 360 Huntington Avenue, Boston MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E David","family":"Zepeda","sequence":"additional","affiliation":[{"name":"Northeastern University Center for Health Policy and Healthcare Research, 360 Huntington Avenue, Boston MA, USA"},{"name":"D'Amore-McKim School of Business, Northeastern University, 360 Huntington Avenue, Boston MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koenraad","family":"Mortele","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary J","family":"Young","sequence":"additional","affiliation":[{"name":"Bouve College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston MA, USA"},{"name":"Northeastern University Center for Health Policy and Healthcare Research, 360 Huntington Avenue, Boston MA, USA"},{"name":"D'Amore-McKim School of Business, Northeastern University, 360 Huntington Avenue, Boston MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,1,23]]},"reference":[{"key":"key\n\t\t\t\t2019012510211141900_mzy248C1","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.2214\/AJR.08.1622","article-title":"Do clinicians use the American College of Radiology appropriateness criteria in the management of their patients?","volume":"192","author":"Bautista","year":"2009","journal-title":"AJR Am J Roentgenol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jacr.2010.07.009","article-title":"Effectiveness of clinical decision support in controlling inappropriate imaging","volume":"8","author":"Blackmore","year":"2011","journal-title":"J Am Coll Radiol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C3","author":"Office of Inspector General","year":"2018"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C4","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1148\/radiol.2343031536","article-title":"Utilization of radiology services in the United States: levels and trends in modalities, regions, and populations","volume":"234","author":"Bhargavan","year":"2005","journal-title":"Radiology"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C5","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1056\/NEJMhpr0808703","article-title":"Health insurers and medical-imaging policy\u2014a work in progress","volume":"360","author":"Iglehart","year":"2009","journal-title":"N Engl J Med"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C6","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s10140-006-0493-9","article-title":"Increasing utilization of computed tomography in the adult emergency department, 2000-2005","volume":"13","author":"Broder","year":"2006","journal-title":"Emerg Radiol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C7","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1001\/jama.2010.460","article-title":"KA. Changes in the use and costs of diagnostic imaging among medicare beneficiaries with cancer, 1999-2006","volume":"303","author":"Dinan","year":"2010","journal-title":"JAMA"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C8","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.jacr.2013.02.023","article-title":"Trends in the utilization of medical imaging from 2003 to 2011: clinical encounters offer a complementary patient-centered focus","volume":"10","author":"Dodoo","year":"2013","journal-title":"J Am Coll Radio"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C9","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.jacr.2011.08.021","article-title":"Trends in the utilization of outpatient advanced imaging after the deficit reduction act","volume":"9","author":"Levin","year":"2012","journal-title":"J Am Coll Radio"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C10","doi-asserted-by":"crossref","first-page":"2400","DOI":"10.1001\/jama.2012.5960","article-title":"Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated heath systems","volume":"307","author":"Smith-Bindman","year":"2012","journal-title":"JAMA"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C11","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1016\/j.juro.2010.12.033","article-title":"Overuse of imaging for staging low risk prostate cancer","volume":"185","author":"Choi","year":"2011","journal-title":"J Urol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C12","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1377\/hlthaff.2011.0336","article-title":"Appropriate and inappropriate imaging rates for prostate cancer go hand in hand by region, as if set by thermostat","volume":"31","author":"Makarov","year":"2012","journal-title":"Health Aff (Milwood)"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C13","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1002\/cncr.26416","article-title":"Inappropriate utilization of radiographic imaging in men with newly diagnosed prostate cancer in the United States","volume":"118","author":"Prasad","year":"2012","journal-title":"Cancer"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C14","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1001\/jamainternmed.2013.3804","article-title":"Overuse of magnetic resonance imaging","volume":"173","author":"Emery","year":"2013","journal-title":"JAMA Intern Med"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C15","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/j.jacr.2014.05.014","article-title":"MRI of the knee and shoulder performed before radiography","volume":"11","author":"George","year":"2014","journal-title":"J Am Coll Radio"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C16","first-page":"68","article-title":"Inappropriate ordering of lumbar spine magnetic resonance imaging: are providers choosing Wisely?","volume":"22","author":"Gidwani","year":"2016","journal-title":"Am J Manag Care"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C17","article-title":"Appropriatness of magnetic resonance imaging requested by primary care physicians for patients with knee pain","author":"Garcia-Gomez","year":"2018","journal-title":"Int J Qual Health Care"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C18","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/j.apmr.2013.10.032","article-title":"Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain","volume":"95","author":"Ma","year":"2014","journal-title":"Arch Phys Med Rehabil"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C19","volume-title":"Health, United States, 2006 with Chartbook on Trends in the Health of Americans (DHHS Publication No. 2006-1232)","author":"Center for Disease Contol and Prevention","year":"2006"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C20","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1016\/j.jpain.2010.07.002","article-title":"The prevalence of chronic pain in United States adults: results of an internet-based survey","volume":"11","author":"Johannes","year":"2010","journal-title":"J Pain"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C21","author":"Centers for Medicare & Medicaid Services","year":"2017"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C22","first-page":"1069","article-title":"ACR appropriateness criteria low back pain","volume":"13","author":"Patel","year":"2016","journal-title":"JACR"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C23","doi-asserted-by":"crossref","first-page":"478","DOI":"10.7326\/0003-4819-147-7-200710020-00006","article-title":"Clinical guidelines diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American","volume":"147","author":"Chou","year":"2007","journal-title":"Ann Intern Med"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C24","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/j.jacr.2011.05.008","article-title":"ACR appropriateness criteria on acute shoulder pain","volume":"8","author":"Wise","year":"2011","journal-title":"J Am Coll Radiol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C25","article-title":"ACR appropriateness criteria on nontraumatic knee pain","author":"Bennett","year":"2012","journal-title":"J Am Coll Radiol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C26","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.jacr.2009.11.010","article-title":"Analysis of appropriateness of outpatient CT and MRI referred from Primary Care Clinics at an Academic Medical Center: how critical is the need for improved decision support?","volume":"7","author":"Lehnert","year":"2010","journal-title":"J Am Coll Radiol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C27","first-page":"156","article-title":"Physical therapy is effective for patients with osteoarthritis of the knee: a randomized controlled clinical trial","volume":"28","author":"Fransen","year":"2001","journal-title":"J Rheumatol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C28","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jacr.2015.08.026","article-title":"Awareness, utilization, and education of the ACR appropriateness criteria: a review and future directions","volume":"13","author":"Sheng","year":"2016","journal-title":"J Am Coll Radiol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C29","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1016\/j.acra.2015.08.011","article-title":"Medical student usage of the American College of Radiology Appropriateness Criteria","volume":"22","author":"Kozak","year":"2015","journal-title":"Acad Radiol"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C30","author":"Timbie","year":"2014"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C31","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1503\/cmaj.141183","article-title":"Effectiveness of interventions designed to reduce the use of imaging for low-back pain: a systematic review","volume":"187","author":"Jenkins","year":"2015","journal-title":"CMAJ"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C32","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1148\/radiol.10100063","article-title":"Addressing overutilization in medical imaging","volume":"257","author":"Hendee","year":"2010","journal-title":"Radiology"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C33","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1056\/NEJM199012063232306","article-title":"Frequency and costs of diagnostic imaging in office practice\u2014a comparison of self-referring and radiologist-referring physicians","volume":"323","author":"Hillman","year":"1990","journal-title":"N Engl J Med"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C34","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1001\/jama.1992.03490150102032","article-title":"Physicians\u2019 utilization and charges for outpatient diagnostic imaging in a medicare population","volume":"268","author":"Hillman","year":"1992","journal-title":"Jama [Internet]"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C35","doi-asserted-by":"crossref","first-page":"2244","DOI":"10.1377\/hlthaff.2010.0413","article-title":"Imaging self-referral associated with higher costs and limited impact on duration of illness","volume":"29","author":"Hughes","year":"2010","journal-title":"Health Aff"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C36","doi-asserted-by":"crossref","first-page":"w415","DOI":"10.1377\/hlthaff.26.3.w415","article-title":"The prevalence of physician self-referral arrangements after stark II: evidence from advanced diagnostic imaging","volume":"26","author":"Mitchell","year":"2007","journal-title":"Health Aff"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C37","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1097\/MLR.0b013e31815dc5ae","article-title":"Utilization trends for advanced imaging procedures: evidence from individuals with private insurance coverage in California","volume":"46","author":"Mitchell","year":"2008","journal-title":"Med Care [Internet]"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C38","doi-asserted-by":"crossref","first-page":"574","DOI":"10.7326\/0003-4819-157-8-201210160-00535","article-title":"The overuse of diagnostic imaging and the choosing wisely initiative","volume":"157","author":"Rao","year":"2012","journal-title":"Ann Intern Med"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C39","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1148\/radiol.10091228","article-title":"Increasing the appropriateness of outpatient imaging: effects of a barrier to ordering low-yield examinations","volume":"255","author":"Vartanians","year":"2010","journal-title":"Radiology"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C40","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/MLR.0000000000000472","article-title":"Reductions in diagnostic imaging with high deductible health plans","volume":"54","author":"Zheng","year":"2016","journal-title":"Med Care"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C41","author":"The Kaiser Family Foundation","year":"2012"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C42","author":"Sullivan","year":"2010"},{"key":"key\n\t\t\t\t2019012510211141900_mzy248C43","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1001\/jama.2012.362","article-title":"Eliminating waste in US health care","volume":"307","author":"Berwick","year":"2012","journal-title":"JAMA"}],"container-title":["International Journal for Quality in Health Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/intqhc\/advance-article-pdf\/doi\/10.1093\/intqhc\/mzy248\/27581019\/mzy248.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,12]],"date-time":"2019-11-12T18:27:30Z","timestamp":1573583250000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/intqhc\/advance-article\/doi\/10.1093\/intqhc\/mzy248\/5299185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,23]]},"references-count":43,"URL":"https:\/\/doi.org\/10.1093\/intqhc\/mzy248","relation":{},"ISSN":["1353-4505","1464-3677"],"issn-type":[{"value":"1353-4505","type":"print"},{"value":"1464-3677","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,23]]}}}