Concerns about unnecessary scans and radiation risk prompt reviews by doctors

Business Week reports on a study that finds 1 in 4 MRI and CT scans are inappropriately recommended by doctors. The study appears in the March issue of the Journal of the American College of Radiology. The researchers analyzed 459 scans at Harborview Medical Center in Seattle. "'Of the 459 reviewed, 74 percent were considered appropriate and 26 percent were considered inappropriate...,' said lead author Dr. Robert L. Bree."

"Bree said the findings are 'important information for policy makers as they struggle with physicians and patients who are unhappy with restrictive utilization management programs and payers and the public who are looking for ways to decrease health care costs and increase quality and safety of exams in an era of higher awareness of effects of excess radiation. A reasonable compromise might be found in the newly emerging clinical decision support systems'" (Preidt, 3/1). 

The Wall Street Journal reports on growing concerns about possible negative side effects from the radiation in CT scans, such as increased cancer risk. "The number of CT scans in the U.S. has skyrocketed to about 70 million a year from just three million annually in 1980. A study in the Archives of Internal Medicine estimated that 29,000 future cancers could be related to CT scans performed in the U.S. in 2007 alone."

Some hospitals are testing programs that could help doctors reduce the number of CT scans they recommend. "Experts say that the best way to reduce the use of CT scans is to encourage doctors to follow guidelines developed by the American College of Radiology and others. Massachusetts General Hospital incorporated thousands of the guidelines into a program that requires doctors to enter information about a patient in the hospital's electronic medical records system before ordering a scan. If the need is questionable or another test might be more appropriate, doctors will get a yellow light. If a scan isn't recommended, it comes up red." Others are working on reducing the amount of radiation needed for certain types of scans (Landro, 3/2).