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Radiologists Now Perform Majority of Lumbar Punctures in Seniors

WEDNESDAY, March 24, 2021 -- Radiologists now perform most lumbar puncture procedures for Medicare beneficiaries, according to a study published online March 4 in the American Journal of Neuroradiology.

Derek R. Johnson, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues analyzed claims data from a 5 percent sample of Medicare beneficiaries (2004 to 2017) to identify lumbar puncture procedures performed by radiologists versus nonradiologist providers. Trends in the performance of lumbar puncture procedures were evaluated.

The researchers found that lumbar puncture use increased from 163.3 to 203.4 procedures per 100,000 Medicare beneficiaries from 2004 to 2017 (overall rate, 190.3). The percentage of lumbar punctures performed by radiologists saw the largest absolute increase (from 37.1 to 54.0 percent), while proportions performed by other major physician specialty groups were unchanged or declined (e.g., neurologists from 23.5 to 10.0 percent). The largest relative increase for the procedure occurred for nonphysician providers (4.2 percent in 2004 to 7.5 percent in 2017). In 2017, more of the lumbar puncture procedures performed by radiologists occurred on weekdays than on weekends (56.2 versus 38.2 percent). Among patients undergoing lumbar puncture by radiologists, comorbidity was slightly higher.

"The continuing shift in lumbar puncture responsibility from other specialists to radiologists has implications for clinical workflows, cost, radiation exposure, and postgraduate training," the authors write.

One author disclosed a financial relationship with Ethos Medical.

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