Navigation Links
Use of unproven mammography tool soars with Medicare coverage
Date:6/14/2010

(SACRAMENTO, Calif.) In a study illustrating the potentially powerful influence of political pressure on medical practice, a UC Davis physician-researcher has found that use of a largely unproven mammography screening device has surged since Medicare began covering its cost.

Joshua Fenton, assistant professor in the UC Davis Department of Family and Community Medicine, with colleagues from the University of Washington and University of Minnesota, examined use of computer-aided detection (CAD), a medical device designed to help radiologists interpret mammograms, since Congress mandated that Medicare pay for it 10 years ago.

He found that the prevalence of CAD jumped from 5 percent in 2001 when Medicare began covering it, to 27 percent in 2003, the most recent year for which data was available. Extra mammography fees for CAD use cost Medicare an estimated $19.5 million in 2003 alone. But actual costs are probably greater because the device has been associated with higher recall rates and greater use of diagnostic tests such as breast biopsy.

The increase in computer-aided detection use occurred even though "systemic reviews point to uncertainty regarding whether CAD has a clinically important impact on key breast cancer outcomes," Fenton writes in today's issue of the Archives of Internal Medicine.

The authors explain that Medicare coverage of the device was key to marketing the device to hospitals and health-care facilities, which resulted in intense lobbying of Congress for approval of CAD as a covered benefit.

"This illustrates how industry and government interact to determine the course of health-care practice, and it's not really guided by science," Fenton said. "This is a case in which expensive technology gets widely adopted in clinical practice before it is proven effective."

Computer-aided detection software analyzes the mammogram image and marks suspicious areas for radiologists to review. In a previous study of more than 200,000 women who had mammograms, published in the New England Journal of Medicine in 2007, Fenton and colleagues found that CAD produced excessive false-positive results. His research demonstrated that when it was used, 32 percent more women were recalled for additional tests and 20 percent more women had a breast biopsy, yet use of the software had no clear impact on the early detection of breast cancer.

"This argues that we need a way of evaluating technologies before we put them into practice," Fenton said. "The government has a huge stake in this. And once the train leaves the station, it's difficult to call it back."

In the current review, Fenton suggests that intense lobbying by manufacturers of the technology, combined with the politically volatile issue of breast cancer screening, resulted in fast-track approval by the government of Medicare coverage of the device. He also argues that industry representatives were better able to market the device, which require a large capital investment of over $100,000, after providers were assured their costs would be reimbursed by the government insurance program.

In an accompanying commentary in the same issue of the Archives, Karla Kerlikowske, professor of medicine, epidemiology and biostatistics at UC San Francisco, says health-care providers and others cannot presume that newer technologies are better than existing ones.

"Health-care providers should not adopt new technologies without first demanding scientific evidence beyond that required for FDA approval," she writes, adding that such evidence should include not just clinical benefits, but also important associated harms and whether benefits outweigh those harms.


'/>"/>

Contact: Dorsey Griffith
dorsey.griffith@ucdmc.ucdavis.edu
916-734-9118
University of California - Davis - Health System
Source:Eurekalert

Related medicine news :

1. Detection of breast cancer in screening mammography has improved over time
2. Palpable breast cancers are more common in women not undergoing annual mammography
3. Breast cancer screening: No added value through mammography
4. Combined mammography and breast MRI useful for some high-risk women
5. ACR, SBI: Avon Survey Reveals Potentially Deadly Effects of USPSTF Mammography Recommendations
6. Carol Milgard Breast Center Awarded Highest Government Rating for Mammography Sites
7. Change in mammography guidelines questioned
8. Digital mammography delivers significantly less radiation than conventional mammography
9. Mammography may increase breast cancer risk in some high-risk women
10. Mammography May Increase Breast Cancer Risk in Some High-Risk Women
11. Underage Drinking Soars in U.S.
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/24/2016)... ... May 24, 2016 , ... PhishLine, the best-in-class, enterprise level ... as Vice President of Sales. Cifolelli’s primary responsibilities include management of the ... rapidly expanding field of organizational social engineering. , “We are delighted to ...
(Date:5/24/2016)... Orion, Clarkston Michigan (PRWEB) , ... May 24, ... ... new Certified Nurse Midwife, Roberta Jordan. , Roberta Jordan is a Certified ... degree from Grand Valley State University and then went on to complete her ...
(Date:5/24/2016)... (PRWEB) , ... May 24, 2016 , ... ... advisory organization, is pleased to welcome new Partner Firm Austin & Co., Inc. ... consultative approach to insurance, employee benefits, HR consulting, benefits technology, and beyond. ...
(Date:5/24/2016)... ... 2016 , ... Local engineering firm, Timmons Group, announced the ... in Woodbridge, VA. The project includes a brand new operating room addition ... new 2 story building houses the Central Sterile department, Sterile prep area and ...
(Date:5/24/2016)... ... ... Mental health watchdog Citizens Commission on Human Rights (CCHR) of Georgia, ... Szasz, is continuing its protest against the use of electroshock (ECT) on children with ... opening of the exhibit follows CCHR’s recent protest at the annual convention of the ...
Breaking Medicine News(10 mins):
(Date:5/24/2016)... 24, 2016 Niederländische Chirurgen ... die es Ärzten erlaubt, ihre Expertise weltweit zu ... kombiniert Live Streaming mit einer Instant-Messaging-Funktion und der ... Mediziner in Europa, Afrika, Asien und den ... die Plattform registriert. Information und Weiterbildung   ...
(Date:5/24/2016)... Cirujanos holandeses han puesto en ... médicos a compartir sus mejores prácticas por el mundo ... médicos de Europa, África, Asia ... aplicación, que combina la transmisión en vivo con mensajería ... Educación   "Imagine un médico de Medicines ...
(Date:5/24/2016)...   , ... primären Endpunkte und demonstriert Ebenbürtigkeit bei der Gesamtreinigung ... plus guter , Reinigung des ...      (Logo: http://photos.prnewswire.com/prnh/20130829/633895-a ) , ... von der MORA-Studie der Phase III für NER1006 ...
Breaking Medicine Technology: