How can we stop the spread of unproven heart scans like CT angiography?

There’s no question that CT scans are among the most overused medical tests.

One newer application has been using CT scans to detect coronary artery calcification for primary prevention of heart disease. It’s a technology of unproven promise, with entities like the USPSTF recommending against it.

Worse, especially in light of the recent data suggesting significant radiation exposure from CT scans, it may even be harmful. Patients need to understand the real risks and uncertain benefits before undergoing the test.

In an editorial from the Archives of Internal Medicine (via Gary Schwitzer), doctors are responsible for the test’s proliferation as well:

Since it seems that the medical community is unwilling to self-regulate in this probably enormously wasteful endeavor, it will require policy makers to be more forceful in reining in the madness, whether it be the Food and Drug Administration or financiers of health care.

We all saw the response to the new breast cancer screening recommendations, where the USPSTF questioning a mammogram’s benefit for women younger than 50 was met with a loud public and political outcry.

Indeed, doctors don’t do a good job self-regulating when it comes to diagnostic tests. But are politicians willing to take an unpopular stand and say “no,” and if so, will patients listen?

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