This NHS HTA funded trial aimed to determine whether early as opposed to delayed, selective imaging significantly impacts on clinical management and patient outcome of low back pain patients referred to a consultant orthopaedic surgeon or neurosurgeon. There were 782 participants recruited across 15 hospitals.

The study concluded that early use of sophisticated imaging does not appear to affect treatment overall. Early imaging was associated with an increase in clinicians’ diagnostic confidence, particularly amongst non-specialists. Decisions about the early use of imaging depend on judgements concerning whether the small observed improvement in outcome justifies the additional costs.