Health policy and the value of imaging research

A look at three articles published in this week's issue of FierceMedicalImaging demonstrates the need for--and the value of--radiology and medical imaging research.

In one article, we explore the continuing debate concerning the efficacy of screening mammography; one opinion piece, in particular, published in the Annals of Internal Medicine, argues that it's time to initiate a new breast cancer screening trial. In particular, the authors say that the old trials don't reflect the advances in modern breast cancer treatment.

Another article, about the future of proton therapy, looks at the need for trials that will help determine the direction the technology should be taking in order for patients to derive benefits from the technology. One thing that proton therapy providers must do going forward is to move away from its reliance on the treatment of prostate cancer, according to John Frick, chairman of the board of the National Association for Proton Therapy.

A third article looks at Amyloid PET imaging, and the need for more research to more clearly determine its eventual role in the diagnosis and treatment of Alzheimer's disease.

What is clear about all three of these disparate radiology issues--mammography screening, proton therapy and Amyloid PET imaging--is that they've all become quite controversial health policy questions. Critics question the expense of proton therapy centers and whether the benefits justify the costs. Then there's the current debate about whether amyloid PET imaging should be covered by Medicare.

As for the screening mammography controversy, that's been going full force since the United States Preventive Services Task Force issued its 2009 recommendations, and shows no sign of dissipation.

These debates are not trivial, and advocates on all sides are pushing their cases strongly. While it's true that there are commercial interests at stake here--for example, Eli Lilly, manufacturer of the imaging agent Amyvid, has much to gain or lose from a decision by the Centers for Medicare & Medicaid Services to cover amyloid PET imaging--more importantly, human lives are at stake.

We can argue about whether health policymakers make the right decisions when provided with a certain amount of scientific evidence. However, it's difficult to argue with the idea that the more evidence we accrue through research, the better decisions policymakers should be able to make.

What's more, we also want our doctors and patients to have access to better information, so they'll be able to make the best possible decisions when it comes to something like breast cancer screening or deciding whether it's worth undergoing an expensive PET scan.

The arguments concerning these and other contentious health policy issues are likely to continue, and will do so until research provides the definitive scientific evidence we're all looking for. - Mike (@FierceHealthIT)

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