On Wednesday, the Joint Commission issued a sentinel event alert which warns of the radiation risks associated with diagnostic imaging. This new alert, coupled with the 2012 CMS accreditation requirement for freestanding imaging facilities, indicates increasing formal attention on radiology and imaging safety procedures.
In an interview with AuntMinnie.com, Joint Commission chief medical officer Ana Pujols-McKee stated that “there’s no single event or reason for the sentinel alert.” Instead, the alert refers to several causes for concern, including two recent studies which placed the incidence of cancer related to CT radiation between 0.02 and 0.04 percent.
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Make sure to join us this Tuesday at 3:00PM EST (8/30/2011) for a Partnership webconference “Next Generation Imaging Data Storage: Strategic Considerations for Adoption”.
As the quantity and complexity of imaging data produced in hospitals and imaging centers steadily grows, radiology leaders are facing extraordinary challenges in keeping up with exploding storage requirements and daunting new regulatory requirements. As next generation solutions for PACS data storage and management emerge, including off-site storage and cloud based sharing, providers arefinding new opportunities to cut their storage costs, fulfill HIPAA requirements, and improve their clinician’s access to information.
This webconference will examine the growing requirements of imaging data storage andmanagement, and provide some guidance for radiology leaders examining potential next generation solutions. Sign up here to reserve your spot.
The appropriateness of mammography screening has long been an issue in the medical community, especially in light of the US Preventive Services Task Force 2009 recommendation against routine mammography screening for women between the ages of 40 and 49 (you can read more of our coverage on the topic here
). With a pair of articles by Kopans et al
and Jorgensen et al
, the September issue of Radiology
continues the debate on the effectiveness of mammography screening in preventing breast cancer mortality and the risk of overdiagnosis.
The key concern when analyzing the appropriateness of mammography screening is that, in Jorgensen’s words, “the goal of screening mammography is earlier detection of only those invasive tumors that would otherwise be lethal.” An unknown percentage of breast cancers, especially ductal carcinoma in situ (DCIS), can remain noninvasive and would never become clinically evident. Though highly contentious, some researchers even suggest that detectable breast cancer can spontaneously regress if left untreated. The authors of both articles disagree about appropriate estimates for these cases of overdiagnosis, with estimates ranging anywhere from 1% or 2% (the low end of Kopans’ estimates) up to 57% (the high end of Jorgensen’s estimates).
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Computerized physician order entry with decision support is part of an expansion in health IT that is central to improving value in health care, according to the former director of the Office of Management and Budget, Peter Orszag. In a Bloomberg opinion piece published last week, Orszag commended the early success of the 2009 HITECH Act, and specifically highlighted the success of Partners Healthcare System in switching to an electronic health record system with integrated clinical-decision support.
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From today's Daily Briefing:
ED patients are undergoing CT scans about four times more frequently than patients in the mid-1990s, according to a study in the Annals of Emergency Medicine.
For the study, University of Michigan Health System researchers and colleagues examined data from the National Hospital Ambulatory Medical Care Survey for 368,680 ED visits at 601 hospitals from 1996 to 2007. The study found that the use of CTs in the ED jumped from 3.2% of all admissions in 1996 to 13.9% of all admissions in 2007.
The largest jump in CT scans was for older patients, the study found. In 1996, about 9.1% of patients over age 79 had a scan in the ED, compared to about 29.1% in 2007. CT scan rates increased most for abdominal pain, chest pain, flank pain, and shortness of breath, according to the findings. Meanwhile, the hospitalization rate for patients who underwent a CT scan fell from 26% in 1996 to about 12% in 2007, while the overall hospitalization rate for ED patients rose from 11% to 13% during that time period.
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In October 2010 the National Cancer Institute announced a premature end to its National Lung Screening Trial after finding that low-dose CT screening of high-risk participants was associated with a 20 percent mortality reduction. Now, as the first formal report of that trial appears in the New England Journal of Medicine, both the trial's researchers and outside parties are raising questions as to whether CT lung screening is ready to be implemented on a broad scale.
A total of 53,454 persons between 55 and 74 years of age were enrolled in the trial, each with a history of cigarette smoking of at least 30 pack years. 26,722 of these participants were randomly assigned to annual screening with low-dose CT and 26,732 to screening with chest radiography. There were 247 deaths from lung cancer per 100,000 person-years of follow-up after screening with low-dose CT and 309 per 100,000 person-years after screening with chest radiography.
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