Monday, November 30, 2009
Too Much Treatment Can be Harmful
Hopefully by now people are realizing that more is not necessarily better. A new study reported at the American Heart Association 2009 Scientific Sessions showed that patients with acute myocardial infarction (AMI) receive large doses of ionizing radiation per hospital admission.
They looked at patients treated at 55 academic hospitals and found, on average, each patient received seven studies per AMI admission. The studies included chest X-rays, chest CT, head CT, nuclear perfusion testing and cardiac catheterization, which added up to about 17.31 mSV of ionizing radiation. The average American receives 3mSV annual radiation from natural sources and 50 is the max exposure allowed in the workplace.
Ionizing radiation has the ability to affect the large chemical molecules of which all living things are made and cause changes which are biologically important.
The researchers did not say that the tests were not indicated. But they pointed out that physicians need to carefully evaluate the indications for tests involving radiation and consider decreasing the dose based on the admitting diagnosis.
With various specialists ordering tests looking at their specific body part, someone needs to be tracking the patient's total radiation dose. We have learned that there is great variation across the country in testing and procedures done, depending upon where the patient is and where the doctor trained. It may be time to take a look at cardiovascular imaging tests and determine if over testing is occurring.
Posted by Toni Brayer, MD at 8:50 PM