Tuesday, January 25, 2005
The (lack of) evidence continues to mount against whole-body CT screening
"The findings indicate that whole-body CT screening exams provide only minimal gains in life expectancy (approximately six days) at an average cost of $2,513 per patient, or an incremental cost-effectiveness ratio of $151,000 per life-year gained (relative to survival with no screening), making the procedure more expensive in cost per life-year gained than the majority of other healthcare interventions currently funded in the United States.
The study also found that for every 1,000 patients screened, an average of 908 would have at least one false-positive test result, requiring further testing. Health insurance would be responsible for the costs of most follow-up tests and treatments prompted by the CT examination, which could lead to increased healthcare costs across the board."
"The findings indicate that whole-body CT screening exams provide only minimal gains in life expectancy (approximately six days) at an average cost of $2,513 per patient, or an incremental cost-effectiveness ratio of $151,000 per life-year gained (relative to survival with no screening), making the procedure more expensive in cost per life-year gained than the majority of other healthcare interventions currently funded in the United States.
The study also found that for every 1,000 patients screened, an average of 908 would have at least one false-positive test result, requiring further testing. Health insurance would be responsible for the costs of most follow-up tests and treatments prompted by the CT examination, which could lead to increased healthcare costs across the board."
Posted by Kevin |
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Comments:
That's a little too "good" to be true. Sounds like distortion to me - distortion by persons protecting financial interests.
It doesn't measure persons in the gray area with signs and symptoms causing concern who haven't crossed all the threshold criteria blocking access to imaging.
It also completely ignores the benefit to patients of finding out about what's wrong, finding out earlier about a terminal or potentially terminal illness. It saved much flailing around and misery in a specific case I am intimately familiar with.
I've posted about my father's "screening" before. It found his renal cell cancer.
Finding it didn't save him - that came too late. A screening a year or two earlier might have, renal cell cancer is asymptomatic in the early stages where cure is possible. What psyician would have ordered a CT when it would have made a difference to longevity? It's almost always an incidental finding when found early.
No the test didn't extend his life. That doesn't meant the screening test was of no benefit. If you can't imagine how, you aren't even human.
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It doesn't measure persons in the gray area with signs and symptoms causing concern who haven't crossed all the threshold criteria blocking access to imaging.
It also completely ignores the benefit to patients of finding out about what's wrong, finding out earlier about a terminal or potentially terminal illness. It saved much flailing around and misery in a specific case I am intimately familiar with.
I've posted about my father's "screening" before. It found his renal cell cancer.
Finding it didn't save him - that came too late. A screening a year or two earlier might have, renal cell cancer is asymptomatic in the early stages where cure is possible. What psyician would have ordered a CT when it would have made a difference to longevity? It's almost always an incidental finding when found early.
No the test didn't extend his life. That doesn't meant the screening test was of no benefit. If you can't imagine how, you aren't even human.
# posted by 
: 12:17 PM
: 12:17 PM
