The New Era of Medical Imaging — Progress and Pitfalls

Medical Student Usage of the American College of Radiology Appropriateness Criteria

“…Several publications have documented that as many as 25%-50% of advanced imaging studies fail to improve patient welfare and may be unnecessary (4)(5)(6)(7). This not only contributes to escalating health care costs in the United States (4,8,9) but also exposes patients to unnecessary risks including radiation, contrast-related complications (7,(10)(11)(12)(13)(14), and unnecessary interventions for incidentalomas (15).…”

The value and appropriateness of positron emission tomography: An evolving tale

“…However, impressions of modern health care have been adversely impacted by runaway expenses and the high cost of care delivery. 1,2 Medical imaging, including nuclear cardiology, has demonstrated excellent value with regards to diagnosis and risk stratification, but has limited date to support its impact on patient outcome, thereby becoming the focus of public and payer attention due to concerns of overuse. 1,2 This has lead to multiple initiatives to limit test performance and reduce overall spending, including pre-authorization and test substitution.…”

“…1,2 Medical imaging, including nuclear cardiology, has demonstrated excellent value with regards to diagnosis and risk stratification, but has limited date to support its impact on patient outcome, thereby becoming the focus of public and payer attention due to concerns of overuse. 1,2 This has lead to multiple initiatives to limit test performance and reduce overall spending, including pre-authorization and test substitution. 1 As a response to fiscal pressures and with a goal of optimizing test/patient selection, appropriate use criteria (AUC) have been developed by several organizations, including the American College of Cardiology (ACC) and American Society of Nuclear Cardiology (AS]NC).…”

“…This study utilized the 2009 RNI AUC, 2 which have now been largely replaced by the AUC for stable ischemic heart disease, published in 2013 as part of the new multimodality approach. 3 These new AUC provide an update based on the newest literature but importantly, reflect a number of methodological changes, including new terms for the categories of appropriate use.…”

The Relationship between Low Back Magnetic Resonance Imaging, Surgery, and Spending: Impact of Physician Self-Referral Status

“…Rapid growth in medical imaging, particularly advanced and costly imaging using magnetic resonance (MR) and computed tomography equipment, has given rise to a range of questions about the value of these procedures (Iglehart 2006;Medicare Payment Advisory Commission 2009). Significant bodies of research demonstrate the ability of new imaging technologies to contribute information valuable to patient care.…”