Is this CT scan necessary?

Is this CT scan necessary?

Summary: There's a lot of work to be done developing cost-benefit analyses of medical imaging. Dr. Baker has uncovered a huge new business opportunity, just in time for Christmas.

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Dr. Laurence Baker, Stanford University MedicalThere are many reasons why health care bills have grown.

Chronic disease. New diseases. Mental health. Drugs.

One that is not often studied closely enough is medical imaging. Are those CT scans really necessary?

Today, in a study partly-funded by the device industry itself, Stanford researcher Laurence C. Baker offered a methodology for finding out whether they are.

His study, published in Health Affairs, looked specifically at how CT scans did in diagnosing abdominal aneuryisms among Medicare patients at Stanford, and found them effective.

Previously these would be diagnosed with a nasty operation called a catheter angiography, in which a tube with a camera would run up the patient's blood vessels.

It found that for every 100 CT scans, 15 of these expensive operations were replaced. That's good. So is the fact that 68 out of each 100 CT scan patients were previously given no diagnostic test at all.

Still, the report suggested, this methodology needs to be applied across a range of conditions, and a range of patients, to calculate the real cost-benefit of the technology.

That's because we already know the cost is very real.

When MRI or CT scanners are put into service, they get used. Using scanners is cheaper than operating on people, but we need to find out which scans are necessary if we're to get any handle on medical inflation.

And there is the breakthrough. There's a lot of work to be done developing cost-benefit analyses of medical imaging. Dr. Baker has uncovered a huge new business opportunity, just in time for Christmas.

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3 comments
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  • I see the need for software that determines needs.. but

    1. Why wouldnt this software have been integrated into EHR systems.
    2. There needs to be an override.
    3. Doctors should be educated to use the advice as a guide and not as the last word.
    4. There should be a guide bar ratio, meaning it should show the percentage the software used to determine the necessity and possibly show it by category. This will assist the doctor in making an ovrride decision.
    Been_Done_Before
    • But first we need data

      Otherwise you don't have basis on which to write the
      software.
      DanaBlankenhorn
  • Instead of replacing the expensive procedures...

    Instead of replacing the expensive procedures... you should find out why they are so expensive. Every doctor will use her stethoscope to hear your heart or do a full physical exam because those things are nearly free or very cheap. We would not be asking "is this CT necessary?" if CTs they were cheap too. Why are CTs so expensive? Ask the manufacturers. (And no, you don't need a radiologist to interpret a CT, you only need a radiology technologist and a costly maintenance contract.)

    Regarding the need for cost-benefit studies... those cost-benefit studies are done everywhere, mostly locally (meaning country-wide). And most are not even published because of their local scope. I have worked on some of them (in my own country) and most of the time (around here) are done to justify some money-saving policy. Sometimes the conclusion is that the procedure has to be done or lot of people will die, sometimes the conclusion is that the procedure can be restricted to only some cases, and sometimes the conclusion is that the procedure can be omitted because the people that will die are not that many while saving lot of money. (Hey, I don't write the policies, I only do the research.)

    So... why are those CTs so expensive?


    Regards,

    MV
    MV_z