Today, cardiac imaging accounts for about 40 percent of patient radiology exposure, and there have been concerns expressed that many cardiologists haven't been fully aware of the risks associated with ionizing radiation and cardiac imaging. In this week's issue of FierceMedicalImaging we report on research that further illustrates the impact cardiac imaging can have on patient radiation exposure. The study, published in the Annals of Internal Medicine, found that the overuse of cardiac stress testing over the course of nearly two decades has resulted in the performance of about 1 million unnecessary tests (most of them conduced with imaging) at a cost of about half a billion dollars.
Last year the New York Times created quite a media storm with an article in which it reported on colonoscopies that ranged in price--depending on the location--from $7,563.56 to $19,438 (including a polyp removal).
When the Choosing Wisely campaign was launched in 2012, the stated goal of the initiative was to "spark conversation" about the necessity of certain frequently ordered tests and treatments. Currently, we are seeing evidence that Choosing Wisely recommendations--many of which are related to radiology and medical imaging--are, indeed, having an impact.
Last December, when the United States Preventive Services Task Force recommended low-dose CT (LDCT) lung cancer screening for high-risk smokers, it was all but a foregone conclusion that the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) would follow suit and recommend it to be covered by Medicare. Of course, that narrative took a different turn this past April when MEDCAC voted not to recommend LDCT screening, much to the dismay of lung cancer screening advocates.
But now, two recent studies seem have supplied evidence that supports lung cancer screening for Medicare patients.
The comment period for the 2015 Medicare Physician Fee Schedule proposed rule ended last week and radiology and imaging-related organizations expressed their concerns about a number of issues, such as the potential for significant reimbursement reductions in radiation oncology services. One area of particular interest to these organizations has to do with the payment for the secondary interpretation of images.
If Cologuard can win approval and gain traction on the path to reimbursement, why not virtual colonoscopy (CT colonograpy)?
The introduction of mammography and colonoscopy back in the 1960s helped introduce an "age of wonder" for cancer screening that correlated with a significant drop in mortality rates, according to Cary Gross, M.D., of Yale Medical School. Conversely, according to Gross, the 21st Century has launched a new age of wonder in the sense that people are now wondering how beneficial cancer screening actually is.
A new report from the Committee on Medical Aspects of Radiation in the Environment in the UK reminds us that efforts are underway to continue to understand and balance the risks and rewards of medical imaging with ionizing radiation.
According to Judith A. Malmgren, M.D, affiliate assistant professor at the University of Washington's School of Public Health and Community Medicine in Seattle, the problem with determining the effectiveness in this age group is the paucity of available research; elderly women don't make good candidates for clinical trials.