Table 4.

Overview of interventions with more than a 30% reduction in use of low-value imaging examinations

Components in interventions	Country	Setting	Reduction	Reference
Clinical decision support system	USA	Hospital	31%	[75]
Feedback to referrers	USA	Hospital	38%	[131]
Multiple measures for referrers, imaging staff, and patients	Canada	Hospital	43%	[81]
Required action from referrers	Canada	Tertiary care center	48%	[117]
Education	USA	Medical center	50%	[37]
Specialist involved in ordering examinations	USA	Hospital	54%-points	[96]
Education and guideline implementation for referrers and imaging staff	USA	Hospital/Emergency department	30–58%	[41, 73]
Combination of new clinical procedures	USA	Hospital	60%	[86]
Education, feedback, and hand-outs	USA	Academic medical center	30–62%	[42, 44]
Guideline implementation	USA, Australia	Hospital/tertiary hospital	50–62%	[69, 80, 108]
Education, alerts, and new procedure for referrers	USA	Hospital/tertiary hospital	35–64%	[83, 116]
Health information exchange	USA	Hospital	61–64% lower odds for repeat examination	[38, 39, 85]