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-indication | Patients with LV procedure (n) | LV (%) | |
| Knee arthroscopy (n=3620) | Broad: osteoarthritis or meniscal derangements | 2956 | 81.7 | −24.2 (−27.5 to −21.3) |
| Narrow: broad with additional criteria | 1607 | 44.4 | −21.1 (−25.8 to −17.1) | |
| Endoscopy; age<55 years (n=5021) | Dyspepsia | 501 | 10.0 | −17.1 (−26.3 to −9.3) |
| Intravitreal injections (n=441) | No indication requiring inpatient care | 427 | 96.8 | 8.2 (3.8 to 11.6) |
| Abdominal hysterectomy (n=298) | Broad: benign disease | 238 | 79.9 | −26.5 (−37.0 to −17.0) |
| Narrow: broad with additional criteria | 92 | 30.9 | −35.5 (−50.6 to −23.4) | |
| Colonoscopy; age<50 years (n=4017) | Constipation | 133 | 3.31 | −23.4 (−38.1 to −11.0) |
| Spinal fusion (n=544) | Broad: low back pain or spinal stenosis | 124 | 22.8 | −6.2 (−28.9 to 11.2) |
| Narrow: only low back pain | 8 | 1.5 | −42.3 (−109.0 to −13.7) | |
| Percutaneous coronary interventions (n=881) | Broad: stable coronary disease | 112 | 12.7 | 51.1 (7.8 to 79.9) |
| Narrow: broad with additional criteria | 110 | 12.5 | 54.2 (14.9 to 83.8) | |
| Adenoidectomy during tube insertion procedure (n=303) | Tube insertion procedure for otitis media with effusion; age≤12 years | 86 | 28.4 | 4.5 (−26.1 to 29.3) |
| Epidural steroid injections (n=83) | Low back pain | 27 | 32.5 | 81.9 (−55.6 to 149.0) |
| Inferior vena cava filter (n=26) | Broad: all patients | 26 | 100 | 52.2 (−42.4 to 104.0) |
| Narrow: broad with additional criteria | 11 | 42.3 | 27.4 (−57.7 to 86.8) | |
| Carotid endarterectomy (n=59) | Broad: asymptomatic, high-risk patients | 21 | 35.6 | −32.1 (−71.2 to −7.6) |
| Narrow: additional criteria | 15 | 25.4 | −23 (−78.1 to 9.6) | |
| Laparoscopic uterine nerve ablation (n=18) | Broad: all patients | 18 | 100 | 52.2 (−42.4 to 104.0) |
| Narrow: chronic pain | 5 | 27.8 | 27.4 (−57.7 to 86.8) | |
| Endovascular repair of abdominal aortic aneurysm (n=28) | Broad: asymptomatic, high-risk patients | 13 | 46.4 | −43.4 (−75.5 to −22.2) |
| Narrow: broad with additional criteria | 5 | 17.9 | −60.8 (−91.4 to −43.8) | |
| Renal artery angioplasty or stent (n=12) | Broad: renovascular hypertension or atherosclerosis | 12 | 100 | 14.2 (−70.3 to 68.1) |
| Narrow: broad with additional criteria | 10 | 83.3 | 8.1 (−79.8 to 48.4) | |
| Retinal laser or cryotherapy (n=437) | Lattice degeneration | 9 | 2.1 | 79.0 (−54.5 to 172.0) |
| Nasolacrimal duct procedure; age≤1 year (n=11) | Blocked nasolacrimal duct | 8 | 72.7 | −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) | Depression | 0 | – | |
| Any of the 21 procedures (n=14 662) | All broad indications | 4695 | 32.0 | |
| All narrow indications | 3044 | 20.8 | ||
| All patients in cohort (n=141 244) | All broad indications | 4695 | 3.3 | |
| All narrow indications | 3044 | 2.2 | ||
Complete low-value procedure definitions are provided in online supplementary table 1.