Sometimes newer isn’t necessarily better.
The NEJM has a study showing that cardiac CT scans weren’t much better than traditional stress tests with imaging in finding coronary artery blockages.
Worse, it had a specificity of 90 percent, meaning there were false positives in 1 of 10 cases.
There is savvy marketing behind cardiac scans, but lost are the facts that they are expensive and expose the patient to significant amounts of radiation. Incidental findings and false positives can lead to further, possibly unnecessary, testing.
Despite this, use of cardiac scans has been increasing by 26 percent annually.
Patients need to be informed of the uncertainty behind newer diagnostic modalities, like heart scans and “virtual” colonoscopies. As Gary Schwitzer points out, major media itself is often confused by medical studies, for instance presenting this study with conflicting headlines.
If you look at the evidence carefully, you’ll see that sometimes images from these scans are “just another pretty picture.”
Merrill Goozner is more blunt, saying that these expensive, unproven tests aimed at the worried well have to be contained if health care costs are to be controlled.
topics: scans, costs
Related posts:
- Lung cancer CT screening produces false positives and isn’t ready for prime time
- Cardiac scans are being overused
- More trouble for CT scans of the heart
- Cardiac CT scans
- The quality of CT and MRI scans vary, and how old machines can affect the treatment course
- Cardiac CT scans
- How many more scans are doctors ordering today?
{ 1 comment }
Kevin,
While clearly there is lots of potential for abuse in CT and other imaging modalities (ie: the roaming truck offering tests without indications). But do you not believe that there is a role for Cardiac CT at all presently? The radiation dose (granted, there is a range) is similar to or less than a typical nuclear stress and offers similar sensitivity and specificity. While clearly not appropriate for the worried well, what about those symptomatic with chest pain and who have risk factors for CAD? Clearly there must be some middle ground.
Comments on this entry are closed.