To the Editor Reducing use of low-value care is now a recognized national priority.¹ The Original Investigation by Hong et al² recently published in JAMA Internal Medicine showed that clinician characteristics, including ownership of imaging equipment, ordering low-value imaging on a prior patient, and high rates of low-value imaging in another clinical scenario, are predictive of low-value imaging for back pain and headache. These findings confirm physician-level variation in use of low-value care found in other studies, and contribute to our understanding of the underlying determinants of use. However, important questions remain regarding appropriateness of use as well as behavioral mechanisms associated with low-value care.

致编辑减少使用低价护理现已成为国家公认的优先事项。¹ Hong等人最近在《JAMA Internal Medicine》上发表的原始研究²显示，临床医生的特征包括：拥有成像设备，在先前患者上订购低值成像以及在另一种临床情况下高价值的低值成像低价值影像学对腰痛和头痛的预测。这些发现证实了其他研究中医师在低价值医疗使用中的差异，并有助于我们对使用的基本决定因素的理解。但是，关于使用的适当性以及与低价护理相关的行为机制，仍然存在重要的问题。