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Clinician, patient and general public beliefs about diagnostic imaging for low back pain: protocol for a qualitative evidence synthesis
  1. Adrian C Traeger1,
  2. Benjamin J Reed2,3,
  3. Denise A O’Connor2,3,
  4. Tammy C Hoffmann4,
  5. Gustavo C Machado1,
  6. Carissa Bonner1,
  7. Chris G Maher1,5,
  8. Rachelle Buchbinder2,3
  1. 1 School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  2. 2 Monash Department of Clinical Epidemiology, Cabrini Institute, Malvern, Victoria, Australia
  3. 3 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  4. 4 Faculty of Health Sciences and Medicine, Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Queensland, Australia
  5. 5 Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, New South Wales, Australia
  1. Correspondence to Dr Adrian C Traeger; adrian.traeger{at}


Introduction Little is known about how to reduce unnecessary imaging for low back pain. Understanding clinician, patient and general public beliefs about imaging is critical to developing strategies to reduce overuse.

Objective To synthesise qualitative research that has explored clinician, patient or general public beliefs about diagnostic imaging for low back pain.

Methods and analysis We will perform a qualitative evidence synthesis of relevant qualitative research exploring clinician, patient and general public beliefs about diagnostic imaging for low back pain. Exclusions will be studies not using qualitative methods and studies not published in English. Studies will be identified using sensitive search strategies in MEDLINE, EMBASE, CINAHL, AMED and PsycINFO. Two reviewers will independently apply inclusion and exclusion criteria, extract data, and use the Critical Appraisal Skills Programme quality assessment tool to assess the quality of included studies. To synthesise the data we will use a narrative synthesis approach that involves developing a theoretical model, conducting a preliminary synthesis, exploring relations in the data, and providing a structured summary. We will code the data using NVivo. At least two reviewers will independently apply the thematic framework to extracted data. Confidence in synthesis findings will be evaluated using the GRADE Confidence in the Evidence from Reviews of Qualitative Research tool.

Ethics and dissemination Ethical approval is not required to conduct this review. We will publish the results in a peer-reviewed journal.

PROSPERO registration number CRD42017076047.

  • low back pain
  • diagnostic radiology
  • beliefs
  • expectations

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  • Contributors ACT, BR, CGM and RB conceived the idea for the study. ACT wrote the first draft of the manuscript. BR, DAO, TH, GCM, CB, CGM and RB contributed to revising subsequent drafts critically for important intellectual content. ACT, BR, DAO, TH, GCM, CB, CGM and RB approved the final version of the manuscript and agree to be accountable for its content.

  • Funding This work was supported by an Australian National Health and Medical Research Council (NHMRC) programme grant entitled ’Using healthcare wisely: reducing inappropriate use of tests and treatments' (APP1113532). ACT, GCM and CB are supported by NHMRC Early Career Fellowships. CM is supported by an NHMRC Principal Research Fellowship. RB is supported by an NHMRC Senior Principal Research Fellowship.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.