I spoke with MITA Executive Director Dave Fischer last week about industry efforts to control radiation dose in diagnostic radiology modalities such as CT.
A congressional hearing on radiation dose control took place the day after we spoke, and the FDA will be holding a hearing on diagnostic radiology issues in late March. Earlier last week, timed in part perhaps because of the upcoming congressional committee hearing, MITA kicked off the dose check initiative, a tool for manufacturers and providers to use in better regulating diagnostic imaging radiation dose, which Dave Fischer describes in our interview. He also referred to the CMS demonstration project on appropriateness of imaging services now underway, authorized by MIPPA.
It now seems surprising that there has been no demand by clinicians, technologists, medical physicists, regulators, accreditation entities, consumer groups or others for this sort of rudimentary standard-setting and introduction of failsafe mechanisms to avoid dangerous levels of medical radiation, and a more rigorous approach to a cost-benefit analysis for CT scan ordering (though the CMS demo is perhaps a good first step). However, media reports about unreasonably high radiation doses in the CT setting at Cedars-Sinai and elsewhere around the country have galvanized our attention so that we have focused on this issue.
Here’s hoping that in the future, areas of concern may be identified empirically and safeguards put in place before patients are harmed.
What are your thoughts on the use of cost-benefit analysis in the development of protocols for diagnostic imaging or other clinical procedures? Are the tools we’ve been using to date adequate? What happens – and what should happen – when clinicians ignore the outcomes of studies in their clinical practice (e.g. in the case of stents vs. medication)?
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