Weighing The Reward of Radiology Information Systems

2013-05-23
 

Medical Imaging In The Cloud

Employing computed tomography (CT) scans has both advantages and risks. CT has led to revolutionary enhancements in the diagnosis and treatment of many diseases, as well as nearly ending the need for exploratory surgery and many other invasive procedures. The risk involved is that a CT scan delivers 70 times as much radiation as a chest x-ray.

Measuring Lifetime Health Risk

Recent articles on the dangers of radiation exposure have focused on how CT increases a patient’s risk of developing cancer in his or her lifetime. In order to examine these dangers, lifetime risk metrics were employed in a recent study published in the online journal, Radiology. According to Pari V. Pandharipande, MD, MPH, who helped conduct the study, the lifetime risks of cancer from medical radiation may be given too much emphasis when compared to the patient’s current pressing health risks. According to the study, the immediate risk of death is a vital factor when taking into consideration the benefits of the exam versus the possibility of radiation-induced cancer in the future.

Timing of Risk Is Critical

Dr. Pandharipande argues that “This [timing] must be considered when physicians make medical imaging decisions for their patients because the timing of risks changes their relevance.”

While modern radiology information systems help improve physician decision-making, it is still up to the individual patient to assess the risk. Dr. Pandharipande adds that “Risks incurred later in life are not the same as those faced in the present. If you had to choose between the chance of incurring a serious risk now or later in life, most people would choose the latter.”

Overestimating Risk of Cancers Later in Life

The study forecasted outcomes in patients with testicular cancer who were undergoing CT exams after orchiectomy. It compared the loss of life expectancy from testicular cancer to life expectancy losses resulting from CT induced cancers with the purpose of quantifying the effects of immediate risk as opposed to future risks. In using these lifetime risk metrics, the researchers discovered that it can lead to overestimating the events that may occur later in life.

According to Pandharipande, more research needs to be conducted into patient and provider risk perception. “Radiation-induced cancer risks, often discussed at the population level, can be challenging to conceptualize and apply to imaging decisions that have to be made at the patient level. We as physicians can benefit from dedicated educational efforts to improve decision-making and better convey the risks to patients,” he concluded.

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