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Need for Less Imaging, Better Understanding

Nortin M. Hadler, MD

JAMA. 2003;289:2863-2865.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In this issue of THE JOURNAL, Jarvik and colleagues¹ detail the benefits and costs that accrued when rapid MRI (magnetic resonance imaging) was substituted for the more traditional radiographs physicians have used when evaluating patients with regional back pain. Rapid MRI is an adaptation of standard MRI, but provides adequate images more rapidly and at considerably less cost. The study shows that substituting rapid MRI neither saved money nor led to improved clinical outcomes. Rather, the data suggest that substituting rapid MRI increases cost in part because it predisposes patients to undergo surgical intervention.

As a result of this randomized controlled trial, rapid MRI joins the ranks of appealing innovations that have proved illusory. Modern medicine is conditioned to be swayed by such a result, as is society at large, and is less conditioned to question the reasoning that generated the experiment in the first place. . . . [Full Text of this Article]

Author Affiliation: Departments of Medicine and Microbiology/Immunology, University of North Carolina at Chapel Hill.

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