November 10, 2008
Advanced Diagnostic Imaging Procedures Become More Widespread
Advanced computer tomography, or CT scans, doubled and magnetic resonance imaging, or MRI scans, tripled per patient over the last ten years, researchers noted on Monday.
"There was really a profound increase," said Dr. Rebecca Smith-Bindman of the University of California, San Francisco, whose research appears in the journal Health Affairs.
The team of researchers from the University of California, San Francisco and the Group Health Center for Health Studies in Seattle conducted the study using data from 377,000 patients enrolled in the Group Health Cooperative in Washington state between 1997 and 2006.
During the 10-year period, the group of patients underwent five million advanced radiology tests.
In 1997, 13.5 percent of the study group had undergone a CT, MRI, or both, and in 2006 it was 21 percent.
The average total imaging cost per patient, per year doubled during the study period, from $229 to $443.
Previous studies have noted similar rises. The Government Accountability Office in July reported that Medicare spending on medical imaging doubled to about $14 billion a year between 2000 and 2006, driven largely by increases in high-tech imaging.
"The patterns of increase were consistent among every group and every disease that we looked at, which makes it a little tricky to figure out how we can target one group or one disease to decrease imaging," Smith-Bindman said. "It's really across the board."
She also found that many advanced tests were being performed in addition to the old tests, such as X-rays, rather then replacing them, which raises cost.
"Like first-time parents taking baby pictures, we may be overdoing it with newer diagnostic imaging tests. Using these tests wisely can detect treatable diseases and save lives. Excess imaging may be too much of a good thing," she said.
She said the benefits of imaging need to be weighed against their risks, including false positive results and the increased radiation exposure associated with CT scans.
"From my point of view, this is a real harm that needs to be balanced against the benefit of CT," Smith-Bindman said.
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