Overscan

Everyone loves CT scans. They can provide useful information to physicians, generate profit for hospitals and imaging centers, and patients think they look pretty cool and high tech.

Alas, there are some downsides. I’ve mentioned radiation exposure before. Now a study by a U of Wisconsin researcher suggests that doing a CT when a patient has the classic signs of appendicitis is not only unnecessary but also puts patients at risk by delaying their time to surgery.

It says something about the inefficiency of hospital workflow that having a CT scan increased the mean time from presentation to surgery by more than 3 hours!

May 25, 2007

2 thoughts on “Overscan”

  1. CT scans are wonderful but the radiation dose does need to be taken into account. Unfortunately the article you highlight largely misses the point. CT is not used to diagnose acute appendicitis. There is in fact little difficulty in diagnosing acute appendicitis. Unfortunately it is easy to diagnose acute appendicitis in people without acute appendicitis and the role of CT is to prevent unnecessary surgury. We are not told how many unnecessary operations were done in the group without CT. The question that needs to be asked is whether the radiation dose and delay caused by CT scan is justified by the reduction in unnecessary operations. The article does not answer this.

  2. Dr Ray,

    I don’t have access to the original journal article, but the MedPage Today summary I referenced says:

    “The rate of negative procedures – no appendicitis found during surgery – was not significantly different between the groups,” i.e. between those who had scans and those who didn’t. So while the article doesn’t directly answer your question, it seems that some who are getting CT are still getting unneeded ops.

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