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Too much of a good thing?


4 Star

Too much of a good thing?

Our Review Summary

There is little doubt that advances in CT imaging technology have revolutionized the way many diseases are diagnosed and monitored. However, rapidly expanding indications for the technology, including full body scans and lung scans, have raised concerns about its potential overuse. This story does a great job of outlining the problem of overuse of CT imaging and the implications of the harms of radiation exposure.

The story is notable for quantifying how many excess cases of cancer can be expected by the increase in radiation exposure. But given the speculative nature of the calculations of cancer risks, the story does a good job of providing the necessary cautions in interpreting these numbers.

The story avoids the tendency to sensationalize the risks outlined by the source articles.  CT scans used primarily for screening tests are rightly criticized.  On balance, this is a very insightful article.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not discuss the costs of the scans.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story may subtly oversell the benefits of treatment.  It is not clear that the source articles provide good information about the number of surgeries avoided, difficult diagnoses made, or lives saved due to CT scanning.  The story inaccurately states that "no-one questions the value of the tests for allowing doctors to quickly diagnose…problems."  There are many problems, even those listed, that can be diagnosed with modalities other than CT that are less invasive, costly or harmful.

Does the story adequately explain/quantify the harms of the intervention?


The story does a good job of describing the harms of radiation exposure due to CT scans. Notably, the story comments on how many excess cases of cancer could be explained by the radiation exposure and that some of the risk is easily avoidable: some scans are unnecessary.

Does the story seem to grasp the quality of the evidence?


The story does a good job of describing the available evidence that CT scans are harmful. The story details that the risk associated from CT scans is extrapolated from radiation exposures at Hiroshima and Nagasaki and from industrial situations.  One study cited in the story used a simulation (dummies receiving radiation in CT scanners.) The critics and proponents of the methodology are both given voice.  The story mentions that studies using more definitive methods are ongoing.  This is excellent detail and balanced analysis.

Does the story commit disease-mongering?


The story does not exaggerate the seriousness or prevalence of cancer, or the risk from radiation exposure.

Does the story use independent sources and identify conflicts of interest?


The story quotes multiple, independent experts who can provide differing perspectives.

Does the story compare the new approach with existing alternatives?


The story mentions other kinds of tests, such as blood tests, MRIs or ultrasound.

Does the story establish the true novelty of the approach?


The story clearly describes that CT scanning is not a new idea but the story speculates that it is being overused with many new indications and uses that may be unnecessary.

Does the story appear to rely solely or largely on a news release?


Because the story quotes multiple experts, the reader can assume that the story does not rely on a press release as the sole source of information.

Total Score: 8 of 10 Satisfactory


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