The latest article from Radiology, August 8, 2012, was reported on by HealthImaging. The results seem conclusive that CCTA can now be depended upon for raising the bar for diagnosing CAD in patients with previously abnormal SPECT scans. But do the results tell the whole story? That’s the question to be answered. Clearly the specificity is better with CCTA but the authors admit the SPECT studies were performed at many sites and not standardized by equipment or protocol. The CCTA was done in a standardized manner. PET might have provided a better result than the other two but what are we seeking? It appears we are still technology centric rather than disease centric.
Read the report at HealthImaging and think about where we go from here.
AHRA reports that ICDs and other causes of accidents and personal injury from the use of MRI have improved remarkably. After reading this report your shoulder or back may suddenly improve and no longer require a scan.
A study recently appeared in the NEJM comparing the average approval times for innovative, high risk medical devices in the U.S. and in Europe. It appears for new devices the approval times are similar overall. I think the key is that these are innovative (new technology) rather than more of the same. The authors of this Perspective study, “based their case on data showing that reimbursement decisions figure as prominently as regulatory ones in delaying—or expediting—patient access to innovative, high-risk devices.”
Grant money is growing for studies examining how we spend our health care dollars. A short while back two different studies questioned the wide spread use of mammography. Last week a study questioned the growing use of imaging in stage 4 Medicare cancer patients. As pressure grows to decrease the cost of health care more studies will question the way we conduct health care as we try to determine a value proposition for each and every test conducted.