September 9, 2019

Medical imaging rates are climbing—despite efforts to bring them down

Daily Briefing

    Physician groups for years have sought to curb rates of unnecessary imaging, but these rates are still on the rise, according to a study published Tuesday in JAMA.

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    Study details

    For the study, researchers looked at patterns of medical imaging between 2000 and 2016 among 16 to 21 million adult and pediatric patients in seven health care systems in the United States, as well as in the Canadian health system in Ontario.

    For the U.S. data, the researchers included patients who received care in integrated health systems like Kaiser Permanente, as well as systems with mixed insurance, including HMOs and PPOs.

    The researchers found that annual growth of CT, MRI, and ultrasound scans were at their highest between 2000 and 2006. However, even though growth rates are not as high as they used to be, imaging rates have still continued to increase year-over-year. Imaging rates increased at an annual growth between 1% to 5% for most age groups in the United States and Ontario between 2012 and 2016, according to the study.

    That said, one type of medical imaging that saw year-over-year decreases were CT scans among children, according to the researchers. These scans declined in the United States from 2009 to 2013 and remained stable through 2016.

    Imaging rates were also slightly lower among those in integrated health systems compared to those in mixed model systems.

    Discussion

    Lead study author Rebecca Smith-Bindman—a professor of radiology, epidemiology and biostatistics, and obstetrics and reproductive medicine at the University of California, San Francisco—said unnecessary imaging scans can harm patients through incidental findings, overdiagnosis, anxiety, and exposure to radiation, which is associated with an increased risk of cancer.

    "Like all aspects of medicine, it's important to make sure imaging is justified, and that the potential benefits are balanced against the potential harms," Smith-Bindman said (HealthLeaders Media, 9/4; Smith-Bindman, JAMA, 9/3).

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