Guidelines for Repeat Imaging

Repeated patient imaging is not always an extravagance leading to  excessive and unnecessary health care costs, according to a new report. 

The report by the American College of Radiology's Harvey L. Neiman Health Policy Institute provides guidelines for health policy researchers to evaluate the appropriateness and efficiency of repeat medical imaging tests.  

One of the report's authors, Neiman Institute CEO and Research Fellow Richard Duszak, M.D., said some health policy influencers and payers have a confusing, ambiguous understanding of what constitutes repeat testing and do not have uniform mechanisms to separate those tests that are valuable and essential from those that have less value.

Dr. Duszak said, "The goal of health reform is to contain costs without impeding patient access to care. Sometimes, health care delivery and payment policies are shaped by a misconception that repeat testing is, by definition, unnecessary and wasteful. This report clarifies the different types of repeat imaging and provides guidelines that can enable evaluation of which tests bring value to both patients and the health care system."

Dr. Duszak continued, "There is a significant difference, for example, between a follow-up CT scan performed to confirm a small lung cancer and thus enable effective treatment, and simultaneous injudicious CT, x-ray and MRI tests for a patient with abdominal pain. In the latter case, only one may be necessary to provide the physician information for a definitive diagnosis. But we don't currently have a uniform clinically meaningful classification system to aid payers and policy makers in defining repeat imaging based on necessity and health care value."

The guidelines were developed with input from multiple health policy researchers and clinical content experts. They provide a framework that can be applied to a wide range of types of testing.