A recent study raises questions about the frequency of doctors' use of elective heart angiograms, which showed no disease in almost 40 percent of patients. BusinessWeek reports: "Doctors may be sending patients too quickly for elective angiograms to detect heart disease, exposing them to radiation and driving up U.S. health-care costs, a study suggests. An analysis of records of about 400,000 patients concluded that 37.6 percent who underwent angiography to find obstructed heart arteries showed evidence of significant blockage, according to research published today in the New England Journal of Medicine. A total of 39.2 percent displayed none."
Researchers noted that the amount of detected disease was lower than expected and "indicates that doctors need better diagnostic tools before deciding to proceed with catheterization for angiograms, said Manesh Patel, a cardiologist at Duke University in Durham, North Carolina, and one of the authors of the study." Additionally, the study's authors said "use of medical imaging tests, including angiograms, has pushed up medical costs. They cited a federal study of Medicare that showed spending on imaging services doubled to $14 billion in 2006 from six years earlier" (Wechsler, 3/10).
The Wall Street Journal: "More than a million U.S. patients undergo the diagnostic test each year at a cost of about $10,000 each, according to government data. In cases where significant obstruction is found, the test helps doctors determine whether a patient should undergo coronary bypass surgery or have a stent implanted to alleviate the problem. ... The study also comes amid growing concern about the exploding use of radiation-based imaging in medicine, which has sparked worries that many patients are electing to get scans that provide little benefit while increasing their risk of cancer" (Winslow, 3/11).
The Associated Press: "The researchers said the findings suggest doctors must do better in determining which patients should be subjected to the cost and risks of an angiogram. The test carries a small but real risk - less than 1 percent - of causing a stroke or heart attack, and also entails radiation exposure" (Ritter, 3/10).