Whitney Palmer

Report Offers System to Separate Useful and Wasteful Imaging

Published on the Feb. 20, 2013, Diagnostic Imaging website

By Whitney L.J. Howell

All repeat images are not created equal. Some are good; some are wasteful. So one radiology policy think-tank introduced a classification system Wednesday that could help determine whether a repeat image is necessary.

According to Richard Duszak Jr., MD, CEO of the American College of Radiology’s Harvey L. Neiman Health Policy Institute, “repeat image” is an overused and undefined term that offers no clarity about a scan’s medical necessity. The institute, , which researches medical imaging use, quality, and safety metrics, published guidance about how to categorize the various types of repeat images.

This paper, entitled “Repeat Medical Imaging: A Classification System for Meaningful Policy Analysis and Research,” aims to help quantify how many imaging studies have beneficial diagnostic value and how many can be avoided as wasteful spending.

“This classification system is in response to what we perceive as a global lack of clarity as to what repeat imaging means in medicine and when it applies to imagining,” said Duszak, who is also a practicing radiologist. “We’ve tried to be as thoughtful as we could be in creating something that would work both now and with future research as people have more and more robust data.”

The system divides medical images into four categories: supplementary, duplicative, follow-up, and unrelated imaging:

• A supplemental image — many of which are medically necessary — would occur during the same clinical encounter but utilize a different modality, such as a non-contrast CT scan and a renal ultrasound to identify kidney stones.

• Duplicative images involve the same modality during the same or subsequent clinical session. These images are taken for a variety of reasons, including the unavailability of previous scans or a change in the patient’s condition.

• Follow-up imaging can involve the same or different modalities during later clinical meetings, such as repeated imaging in cancer patients to verify there’s been no relapse of disease.

• Unrelated imaging — scanning of the same body area with any modality — is often an unforeseen event. For example, in its paper, HPI discussed unrelated imaging in a woman who had CT screenings for breast cancer staging two weeks prior to a car accident that prompted identical scans.

In many instances, how well researchers will be able to use this classification system will depend on how integrated and mineable the electronic health records they use are, Duszak said, as well as how standardized radiology reports are.

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/practice-management/content/article/113619/2129299

February 26, 2013 - Posted by wjpalmer | Healthcare | classification for repeated diagnostic images, defining "repeat image", duplicative repeated images, follow-up repeated images, Gail Rodriguez, Harvey L. Neiman Health Policy Institute, Medical Imaging and Technology Alliance support repeated images classification system, MITA, Richard Duszak Jr., supplementary repeated images, unrelated repeated images