Reduction in Radiation Exposure to Children and Young People from CT Scans

Reduction in Radiation Exposure to Children and Young People from CT Scans

Children Diagnostic testing Radiation therapy

The Australian Commission on Safety and Quality in Health Care has published a range of resources aimed at reducing unnecessary radiation exposure to children and young people from CT scans. They estimate that over 80,000 CT scans are performed on children and young people in Australia each year, and although they are a valuable diagnostic tool, they use a higher level of ionising radiation than other types of imaging. 

The resources include brochures for parents and carers outlining the benefits and risks of CT scans - available at http://www.safetyandquality.gov.au/ctscansforkids, a fact sheet for referring doctors to provide information on the typical radiation doses and the key questions to consider when deciding whether to refer a child for a CT scan, and an online training module from the Australian Institute of Radiography to support radiographers who undertake CT scans for children and young people. 

More information can be found on the dedicated ACSQHC pages, as well as at Healthdirect, which has partnered with the Commission to develop these resources and others. See http://www.healthdirect.gov.au/ctscansforkids

Unnecessary and Harmful Tests

Unnecessary and Harmful Tests

Diagnostic testing Doctors Health outcomes Surgical procedures

Internationally, there is a groundswell of activity seeking to identify and reduce the use of health care interventions that deliver marginal benefit, be it through overuse, misuse or waste. A special ABC Four Corners investigation reveals many of the treatments and tests we get are unnecessary, sometimes harmful and needlessly expensive, costing the health system billions of dollars every year.
Figures from the Australian Institute of Health and Welfare show Australia spends just under $155 billion on health each year, and it is estimated that one-third of that amount — about $46 billion — is being squandered. This is total spending by federal and state governments, private health insurance and in hard cash from patients in gap fees.

"Adam Elshaug, Associate Professor of Healthcare Policy at Sydney University, is an authority on what is called low-value care and has identified at least 150 unsafe, inappropriate or ineffective medical services that receive Medicare and health insurance rebates." You can read more on this story by Norman Swan and Claudine Ryan from ABC Radio.

Click here to read the full ABC story. You can also read the recent article in the Medical Journal of Australia on the same topic: 

Adam G Elshaug, Amber M Watt, Linda Mundy and Cameron D Willis. (2015), Over 150 potentially low-value health care practices: an Australian study. Med J Aust, 197(10), 556-560.

How well do health professionals interpret diagnostic information?

How well do health professionals interpret diagnostic information?

Diagnostic testing Doctors

The most important finding of this systematic review is the lack of understanding of test accuracy measures by health professionals. Published in BMJ  Open, the results of the systematic review of the evidence on test interpretation found that, across multiple studies, clinicians do not accurately interpret common measures of test accuracy such as likelihood ratios.
 

How well do health professionals interpret diagnostic information? A systematic review

Whiting PF, Davenport C, Jameson C, Burke M, Sterne JAC, Hyde C, et al
BMJ Open. 2015 [epub]. 

Too much medicine - Big Ideas

Too much medicine - Big Ideas

Diagnostic testing Drug therapy Medline

A recent lecture in the Sydney Ideas series was entitled Highlights of too much medicine: exploiting fear for the pursuit of profit.  Retired GP Iona Heath is concerned that, despite the best of intentions, modern medicine may be doing more harm than good. She examined and critiqued the health system and argued that greed and profit are at the centre of a self perpetuating cycle of fear, over diagnosis and over servicing.

ABC's Big Ideas recorded highlights of the talk and you can listen to it or download it at their website here.  You can also read an essay by Heath published in the BMJ late last year, entitled Role of fear in overdiagnosis and overtreatment—an essay by Iona Heath

Iona Heath's talk was presented by the School of Public Health, University of Sydney, Sydney Ideas and the Centre for Research in Evidence Based Practice - Bond University on 5th Aug 2015.

National Bowel Cancer Screening Program report 2011-12

National Bowel Cancer Screening Program report 2011-12

Cancer Diagnostic testing

The National Bowel Cancer Screening Program : July 2011-June 2012 monitoring report has been released by the AIHW.  It presents statistics on the National Bowel Cancer Screening Program for Australians invited to take part during this period, when over 320,000 people were screened, with about 22,500 found to require further assessment. One out of every 15 assessments recorded detected an advanced adenoma (pre-cancerous lesion), and a bowel cancer was detected in 1 out of every 32 assessments.  

The National Bowel Cancer Screening Program (NBCSP) aims to reduce the incidence, illness and mortality related to bowel cancer in Australia by screening to detect cancers and pre-cancerous lesions in their early stages.  As in previous years, women were more likely to screen than men, but men had higher rates of screen-detected bowel cancers and overall incidence and mortality.  Aboriginal and Torres Strait Islander participants, those who lived in regional and remote regions and in areas of lower socioeconomic status, had higher rates of positive screening, yet lower rates of follow-up colonoscopies than other participants.