CT in COPD: just a pretty picture or really worth a thousand words (or dollars)?

摘要

We like pretty pictures and, in pulmonary medicine, we use computed axial tomography (CT) to generate pretty pictures to help us diagnose and manage patients with respiratory complaints. In 2007 more than 10 million chest CT scans were performed across the USA, representing an astounding 11 000% increase in the CT rate since 1980. CT scans rely on ionising radiation to generate images, and recent estimates suggest that CT scans may be responsible for 24% of the total 'background' radiation to which the population is exposed in a given year. Thankfully, there are several large-scale efforts to reduce the radiation exposure related to CT scans and to mitigate the health risks imposed by ionising radiation. What is not being adequately addressed is the issue of economic costs (and benefits) of CT scans. CT scans are expensive for patients and to the healthcare system, with prices ranging from Dollars 500 to Dollars 1500 per scan.