You gotta love technology. Sometimes the medical science types can come up with a test that is so……….so………..all inclusive, that it falls short in the category of providing statistically significant useful information. One such critter is the “Ultrafast CT scan”.
Most of us have heard of CT scans. They have been around for over 20 years and have been very useful in analyzing such things as cancer, the brain and most internal organs. Where it has fallen short is it’s ability to scan anything that moves. In layman’s terms, it takes such a long, slow, detailed picture, that if something is moving it would be blurred. A great example of an organ that cannot be scanned using traditional CT equipment is the heart.
Well now, or at least in the very recent past, along comes the ultrafast CT, which snaps a much quicker picture. Now mind you it still doesn’t take a perfectly clear picture, but they have apparently improved it to the point where it can detect calcification in the veins.
Oh my gosh!!!! Calcification can’t be good. I know what happens to my shower head when it gets mineral buildup, and it’s no fun. Sorry! Didn’t mean to alarm anyone. Anyway, some heart disease specialists decided that calcification might very well mean coronary artery disease. The problem is it also might just mean that you have some calcification, which by the way, most anyone over age 25 or 30 does have.
So the problem has been to try to quantify and qualify the results of the ultrafast CT so that the scan can dependably detect those with real heart problems and not freak out those without real problems. This is important. Especially important for those folks running around the country selling a trip through their ultrafast CT machine for $400 a pop. If they start freaking out the wrong people, they’ll have to lower the price to get people to do it.
In their efforts to come up with some kind baseline, there has been something of a dilemma. It seems that what the testers deem as significant calcification does not seem to correlate to a high incidence of coronary artery disease, and what the testers deem as insignificant calcification does not seem to correlate to an absence of heart disease. Keep in mind that this new “non invasive” test was heralded as a way to avoid invasive testing. It appears that, due to the inconclusive results of the test, the only way to really find out what the results mean is to go in and have a look………..INVASION!!!!!
Dr Joseph Mercola kind of summed up one view of this whole thing on his website, www.mercola.com, like this. “Every time a new non-invasive heart test is invented, it is hailed as bringing us one step closer to the day when invasive tests will no longer be necessary. And yet, as time goes by and the new non-invasive test comes into common use, more and more invasive tests end up being performed. This is not a mysterious or inexplicable result. It is entirely predictable.
And that’s the Dirty Little Secret. To wit: every new non-invasive test creates a brand new category of “false positive” results that need to be followed up by performing an invasive test. Therefore, each time a new non-invasive test comes into use, the need to perform invasive procedures increases.
For Ultrafast CT scans, this truism applies in spades, because, as we have seen, a cutoff calcium score has been selected that guarantees a significant proportion of falsely positive tests.
So cardiologists lucky enough to work in hospitals that were “early adopters” of Ultrafast CT scanners, and that advertised them sufficiently, found that their catheterization volume increased significantly. They learned to like the Ultrafast CT scan very much, and found themselves willing to appear in commercials promoting this effective screening tool. Cardiologists in neighboring hospitals, feeling the impact of paying customers being siphoned off by (and being catheterized at) rival institutions, tended to react rather passionately and publicly themselves, but in the opposite direction.
I knew there was a point I wanted to make. As these tests become more readily available, more and more results from them are showing up in medical records where life insurance underwriters are seeing the results. Since underwriters always err on the side of caution, they, of course, have a tendency to freak out even though there may be further testing that rules out heart disease.
Just think what an underwriter could do with the results of a full body scan!!!
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