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Self-referral leads to more negative exams for patients
Date:11/29/2011

al interest in the equipment (NFI group).

For each group, the researchers analyzed the number of abnormalities per positive scan, the mean age of the patients and the negative exam result rate.

The results of the study showed that among the 500 MRI exams (250 per group), between the two groups there was no significant difference in the number of abnormalities per positive scan. However, the mean age among patients in the FI group was 49.6, compared to 56.9 for the NFI group.

There were 86 percent more negative scans in the FI group than the NFI group, indicating a significantly higher number of potentially unnecessary exams. Of the 163 negative exams, 106 belonged to the FI group, compared to 57 for the NFI group. In the FI group, 42 percent of patients referred for exams had negative scans, compared to 23 percent of the NFI group.

"Orthopedic surgeons with financial interest in the equipment had a much higher rate of negative lumbar spine MRIs," Dr. Paxton said. "In addition, they were much more likely to order MRI exams on younger patients. This suggests that there is a different clinical threshold for ordering MRI exams in the setting of financial incentivization."

Dr. Paxton added that increased imaging utilization due to self-referral may not yield medically useful information and may place the patient at risk for potential adverse consequences.

"It is important for patients to be aware of the problem of self-referral and to understand the conflict of interest that exists when their doctor orders an imaging exam and then collects money on that imaging exam," he said.


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Contact: Linda Brooks
lbrooks@rsna.org
630-590-7762
Radiological Society of North America
Source:Eurekalert

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