Table 1

Low-value (LV) counts and percentage of patients with the LV procedure out of all patients with the procedure, for 21 hospital procedures

2014% Change 2010–2014 (95% CI)
Patients with procedure (n)LV patient-indicationPatients with LV procedure (n)LV (%)
Knee arthroscopy (n=3620)Broad: osteoarthritis or meniscal derangements295681.7−24.2 (−27.5 to −21.3)
Narrow: broad with additional criteria160744.4−21.1 (−25.8 to −17.1)
Endoscopy; age<55 years (n=5021)Dyspepsia50110.0−17.1 (−26.3 to −9.3)
Intravitreal injections (n=441)No indication requiring inpatient care42796.88.2 (3.8 to 11.6)
Abdominal hysterectomy (n=298)Broad: benign disease23879.9−26.5 (−37.0 to −17.0)
Narrow: broad with additional criteria9230.9−35.5 (−50.6 to −23.4)
Colonoscopy; age<50 years (n=4017)Constipation1333.31−23.4 (−38.1 to −11.0)
Spinal fusion (n=544)Broad: low back pain or spinal stenosis12422.8−6.2 (−28.9 to 11.2)
Narrow: only low back pain81.5−42.3 (−109.0 to −13.7)
Percutaneous coronary interventions (n=881)Broad: stable coronary disease11212.751.1 (7.8 to 79.9)
Narrow: broad with additional criteria11012.554.2 (14.9 to 83.8)
Adenoidectomy during tube insertion procedure (n=303)Tube insertion procedure for otitis media with effusion; age≤12 years8628.44.5 (−26.1 to 29.3)
Epidural steroid injections (n=83)Low back pain2732.581.9 (−55.6 to 149.0)
Inferior vena cava filter (n=26)Broad: all patients2610052.2 (−42.4 to 104.0)
Narrow: broad with additional criteria1142.327.4 (−57.7 to 86.8)
Carotid endarterectomy (n=59)Broad: asymptomatic, high-risk patients2135.6−32.1 (−71.2 to −7.6)
Narrow: additional criteria1525.4−23 (−78.1 to 9.6)
Laparoscopic uterine nerve ablation (n=18)Broad: all patients1810052.2 (−42.4 to 104.0)
Narrow: chronic pain527.827.4 (−57.7 to 86.8)
Endovascular repair of abdominal aortic aneurysm (n=28)Broad: asymptomatic, high-risk patients1346.4−43.4 (−75.5 to −22.2)
Narrow: broad with additional criteria517.9−60.8 (−91.4 to −43.8)
Renal artery angioplasty or stent (n=12)Broad: renovascular hypertension or atherosclerosis1210014.2 (−70.3 to 68.1)
Narrow: broad with additional criteria1083.38.1 (−79.8 to 48.4)
Retinal laser or cryotherapy (n=437)Lattice degeneration92.179.0 (−54.5 to 172.0)
Nasolacrimal duct procedure; age≤1 year (n=11)Blocked nasolacrimal duct872.7−58.4 (−97.1 to −39.0)
Hyperbaric oxygen therapy (n=28)Multiple indications<5
Gallbladder removal during obesity surgery (n=11)Obesity surgery, no gallbladder disease<5
Open obesity surgery (opposed to laparoscopic) (n<5)Primary bariatric procedure<5
Vertebroplasty (n<5)All patients<5
Electroconvulsive therapy; age≤12 years (n=0)Depression0
Any of the 21 procedures (n=14 662) All broad indications469532.0
All narrow indications304420.8
All patients in cohort (n=141 244) All broad indications46953.3
All narrow indications30442.2
  • Complete low-value procedure definitions are provided in online supplementary table 1.