Health News Review

I found a Medscape story about the following.  Nothing else.  Granted, I can’t see/find everything, so I may have missed some reporting on this.  But nothing jumped out at me in a web search.  Why not?

A paper in JAMA Internal Medicine, “Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes,” was worthy of attention.

In a nutshell, the researchers found that noninvasive cardiac imaging actually led to a lot of invasive tests.  The hospitals that do more noninvasive imaging do more invasive angiography.  But none of this results in better outcomes.  That’s an oversimplification of an important piece of work.

What are noninvasive cardiac imaging tests? Stress nuclear myocardial perfusion imaging, stress echocardiography, cardiac positron emission tomography, cardiac magnetic resonance imaging, and cardiac computed tomography with coronary angiography (CTCA) with or without calcium scoring.

In its story, Medscape had no trouble seeing importance in the study.  Their headline, “Cardiac Imaging Tests Beget More Tests, but No Benefit,” was appropriate. But you’ll also learn from reading the physician comments left in response to the story.  You may not feel better after reading them, but perhaps you’ll learn from reading some of the defensive reactions.

Maybe big news organizations should spend more time looking at studies like this than reporting on a fistbumping study involving 2 subjects…or re-publishing news releases because they say they can’t find enough good news elsewhere – both of which occurred in recent weeks.

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Comments

Bruce Parker posted on February 25, 2014 at 10:29 am

Gary: This is but one of many instances where testing leads to more testing, but not to overall clinical benefit. Recent estimates of benefit from mammograms between 40-50 are that each mammogram adds 3 minutes to life expectancy. Benefit, yes – but rather small.
Let me reiterate: the most strident and effective voice inside western medicine in North America remains Jerry Hoffman, now at USC. Forward! Bruce Parker

Daniel Pendick posted on February 26, 2014 at 4:31 pm

One of the doc’s that commented on Medscape.com stated that the solution was to put people on staff so they cannot be personally sued. I wonder if anyone has taken a look at Cleveland Clinic or Mayo, where I believe they are on staff and paid by a not-for-profit foundation. Do they order less testing there? I suspect they don’t, because the overtesting is also driven by patient demand/expectation.