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Diagnostic Imaging on the Rise Even in 'Accountable' HMOs

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Radiation Exposure Comes at a Risk

The findings of Dr. Smith-Bindman and his colleagues suggest that when ordering diagnostic tests, physicians must consider, and discuss with patients, the risks of radiation, said Dr. George T. O’Connor and Dr. Hiroto Hatabu.

The number of people who receive high or very high annual exposure to ionizing radiation from imaging studies is not trivial. It may even be appropriate for clinicians to consider the cumulative radiation exposure a given patient has received in recent months or years, they added.

Dr. O’Connor is with the pulmonary center at Boston University and is a contributing editor at JAMA. Dr. Hatabu is in the department of radiology and the center for pulmonary functional imaging at Brigham and Women’s Hospital and Harvard Medical School, Boston. Dr. O’Connor reported no relevant financial disclosures, and Dr. Hatabu reported receiving grant support from Toshiba Medical, Canon, and AZE. These remarks were taken from their editorial comments accompanying Dr. Smith-Bindman’s report (JAMA 2012;307:2434-5).


 

FROM JAMA

The increase in the use of CT scanning accounted for much of the overall rise in radiation exposure. In 1996, 30% of patients’ exposure to ionizing radiation was attributed to CT studies; by 2010, 68% of exposure was attributed to CT studies.

"The increase in use of advanced diagnostic imaging has almost certainly contributed to both improved patient care processes and outcomes, but there are remarkably few data to quantify the benefits of imaging. Given the high costs of imaging – estimated at $100 billion annually – and the potential risks of cancer and other harms, these benefits should be quantified, and evidence-based guidelines for using imaging should be developed that clearly balance benefits against financial costs and health risk," Dr. Smith-Bindman and her colleagues said.

This study was funded by the National Cancer Institute and the National Institutes of Health. No financial conflicts of interest were reported by Dr. Smith-Bindman and her coinvestigators.

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