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JAMA opinion piece slams our addiction to ‘unnecessary’ MRIs, CT scans

The authors urge research on how to reduce medical imaging. (iStock)

When the Food and Drug Administration approved magnetic resonance imaging (MRI) scanners in 1984, the machines seemed incredible. They offered an inside view of the human body, making it easier to diagnose disease, injuries and physical abnormalities. Today, they’re part of a multibillion-dollar industry: In 2016, 118 out of every 1,000 Americans got an MRI. The use of CT scans was even higher: 245 per 1,000 people in 2016.

But was all of that testing actually necessary?

No way, say physicians from the Mayo Clinic and Stanford University. In a viewpoint article in JAMA, they argue that it’s time to put the brakes on unnecessary and wasted diagnostic imaging.

“There is virtually no evidence that screening of this kind improves overall population health,” write Ohad Oren, Electron Kebebew and John P.A. Ioannidis. But, they admit, it will take a lot to wean Americans off their addiction to medical imaging.

When it comes to this imaging, more doesn’t necessarily mean better. Imaging can expose patients to radiation. Some patients can suffer side effects from the contrast material that is injected into their bodies before some scans.

Unnecessary imaging can also detect abnormalities that aren’t related to the reason the test is being performed, they write. These mostly incidental findings can serve as red herrings, causing diagnoses that aren’t useful, leading to treatments that don’t work, and causing stress and anxiety to patients.

The authors urge research on how to reduce imaging. They throw out some ideas, such as using image sensitivity settings that focus only on the systems being tested or prohibiting certain studies for certain symptoms that don’t call for that kind of imaging.

“While information can be useful, too much information can create numerous problems,” the physicians write. But now that imaging is so common, many patients crave as much information as possible — even when it won’t necessarily reveal anything useful about their conditions. Breaking that habit may be difficult, but the savings in medical costs, unnecessary treatment and stress will be worth it. Read the article on the JAMA website.

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