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Stanford University - Medical School

• Stanford Medical Study Background

  Findings to Date
  • Our initial work focuses on the use of CT angiography for diagnosis of carotid artery narrowing, which can indicate an increased risk of stroke.
  • We find that use of CTA can substitute for more invasive catheter-based testing, which should benefit patients by reducing the risk of complications.
  • Also, expanded use of CTA can be associated with significant increases in the number of patients who get any advanced testing for carotid artery narrowing, without increasing the probability that they will receive treatment for a problem.
  • This raises questions about how the relative costs, in the form of costly additional testing for patients that does not turn up more treatable disease, compare to the benefits, in the form of reduced side effects for patients that can now get CTA rather than catheter-based tests.
  • Other aspects of the project are documenting a clear link between the availability of imaging technology and its use.
  Impact
  One of the most important challenges facing the American health care system is the management of new medical technologies. These often come with great potential to produce important benefits for patients, but can also be costly enough to put pressure on health care financing mechanisms.
  
  Coming to terms with these challenges will require useful information about relationships between new technologies, costs and health.
  
  Our results thus far do not clearly come out either suggesting that more imaging diffusion is always good or that it is always a problem. Indeed, we take them more as an indication of the importance of pursuing policies that would not discourage the adoption of services, so that they are available where there is benefit, but would provide mechanisms to monitor the use of new technologies that can easily end up overused.
  
  Imaging