Appropriateness of knee MRI prescriptions in a hospital of Birjand, 2014


  • Marjan Vejdani Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran
  • Yasamin Molavi Taleghani PHD student of Health Services Administration, Health Management and Economics Research Center, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
  • Amir Reza Kachooei Department of Orthopedics, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
  • Roghayeh Hosseini Department of MRI, Vali-e-Asr Hospital, Birjand University of Medical Sciences, Birjand, Iran
  • Sirvan Salehi Department of MRI, Vali-e-Asr Hospital, Birjand University of Medical Sciences, Birjand, Iran
  • Samira Foji School of Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran
  • Maryam Goudarzian Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran
  • Ghasem Fattahzadeh-Ardalani Department of Neurology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran



Appropriateness, MRI, Hospital


Background: Knee pain is one of the most common complains which cause patients to visit a doctor and Magnetic Resonance Imaging (MRI) is one of the common diagnostic methods which are common to find the cause of Knee pain. This study aim to determine knee MRI appropriateness, in Valiasr hospital of Birjand in 2014.

Methods: In this study descriptive – analytical study, 150 patients referred to MRI unit were selected using convenient sampling method. Data were gatherers using a Questionnaire and then analyzed by SPSS16 using descriptive statistics and Pearson, chi-square and Fisher's exact tests.  

Results: Of 150 cases, 70 (46.7%) were considered inappropriate, 7 (4.7%) were uncertain, and 73 (48.7%) were deemed to be appropriate. The economic burden of inappropriate prescriptions was 46200000 Rails. A statistical significant relation was observed between appropriateness of prescription with sex, jobs, education, physician specialist and referring institution.

Conclusions: Considering the high rate of inappropriate prescriptions, it is necessary to find the causes. Developing, customization, and perform clinical guidelines in all of our country may help reducing this rate.


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Yazdani S, Mirshahi S. A case of displacement metallic foreign object intraocular during MRI. Journal of Ophthalmology Bina 2002;8(2):186-90.

Rezaei Y, Rahimnia A, Mirmohamad SM, Vaziri K, Fakhrejahani F. Sensitivity and specificity of MRI and Arthroscopy in knee joint injuries. Tehran University Medical Journal 2007;65(9):47-52.

Ryahi ÂN, Salar S, Rahimi S. Designing protocol of MR for angiography of lower limbs using MRI instrument 1.5 Tasla . J Mazandaran Univ Med Sci 2004;14(42):98-107.

Barzin M, Abdi R, Gholmohamadi H. Diagnostic accuracy of ultrasonography in comparison with magnetic resonance imaging in patients with knee trauma. J J Gorgan Uni Med Sci 2012;14(3):92-7.

Ebrahimipour H, Mirfeizi SZ, Vafaee Najar A, Kachooei AR, Ariamanesh ASH, Ganji R, et al. Developing an Appropriateness Criteria for Knee MRI Using the Rand Appropriateness Method (RAM)-2013. Arch Bone Jt Surg 2014;2(1):47–51.

Ostovar R, Rashidian A, Pourreza A, Rashidi BH, Hantooshzadeh S, Ardebili HE, et al. Developing criteria for cesarean section using the RAND appropriateness method. BMC Pregnancy Childbirth 2010;10:52.

Lehnert BE, Bree RL. 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? Journal of the American College of Radiology: JACR 2010;7(3):192-7.

Ebrahimipour H, Mirfeizi SZ, Vejdani M, Vafaee-najar A, Kachooei A, Ariamanesh AS, et al. Evaluation of Medical costs resulting from Magnetic Resonance Imaging inappropriate prescriptions for Knee joint, using RAND Method in Ghaem Hospital- 2013. Hakim Research Journal 2015;17(4).

News IR. Administration unnecessary medical services and treatment, way to earn more income. 2013 80651732.

Salari H, Ostovar R, Esfandiari A, Keshtkaran A, Sari AA, Manesh HY, et al. Evidence for Policy Making: Clinical Appropriateness Study of Lumbar Spine MRI Prescriptions Using RAND Appropriateness Method. International Journal of Health Policy and Management 2013;1:1-5.

Bergh TH, Steen K, Lindau T, Soldal LA, Bernardshaw SV, Lunde L, et al. Costs analysis and comparison of usefulness of acute MRI and 2 weeks of cast immobilization for clinically suspected scaphoid fractures. Acta Orthop 2015;86(3):303-9.

Charles EP. The methodologic fondations of studies of the appropriateness of medical care. The England Journal of Medicine 1993;1329(17):1241-45.

Cutler MD. A Guide to Health Care Reform. Journal of Economic Perspectives. 1994;8(3):13-29.

Keshtkaran A, Bagheri MH, Ostovar R, Salari H. Developing Criteria for Lumbar Spine Magnetic Resonance Imaging (MRI) using RAND Appropriateness Method (RAM). Iran J Radiol 2012;9(3).






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