Stroke Patients Receiving Excessive Brain Imaging

Redundant stroke neuroimaging increasing care costs

(RxWiki News) As technology has improved, so has brain imaging technology for stroke patients. But some researched are concerns patients may be receiving duplicate tests that unnecessarily increase costs.

University of Michigan researchers have found that 95 percent of stroke patients received both magnetic resonance imaging (MRI) and a computed tomography (CT) scan.

"Follow your neurologist's recommendation for imaging tests."

Dr. James F. Burke, lead author of the study and a clinical lecturer in the University of Michigan Medical School's department of neurology, emphasized that as compared to CT, MRI is a more accurate stroke test. However, he said study findings indicated that MRIs have not replaced CT as the primary stroke neuroimaging test.

Instead most patients are receiving both. Minimizing the use of both could reduce care costs, Dr. Burke said.

Researcher studied 624,842 stroke patients from 11 states between 1999 and 2008. They discovered that while MRI use varied regionally, its overall use had increased substantially.

There are currently no evidence-based guidelines recommending a CT or MRI, but the study revealed that utilizing both tests was the largest driver of increased costs. Inpatient stroke care increased 42 percent between 1997 and 2007, an average of $3,800 per patient.

Imaging tests increased in use by 213 percent from 1999 to 2007, making it the fastest growing factor in total hospital costs. Dr. Burke said the current stroke brain imaging practices are neither standardized or efficient, and represent an area where costs could be reduced without sacrificing the level of care.

In an accompanying published editorial Drs. S. Clairborne Johnson and Stephen L. Hauser, editors of journal Annals of Neurology, found that the redundant testing was problematic.

"The issue of duplicative imaging in stroke is just one example of wasteful care. Quite simply, it is very easy to order more tests and to treat with more expensive therapies," they wrote.

The study was recently published in journal Annals of Neurology.

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Review Date: 
March 5, 2012