Dear AuntMinnie Member,
A new wrinkle in the debate over CT lung cancer screening has appeared with the publication of two editorials in the Journal of the American Medical Association that aim to strike a middle ground.
As you probably know, the U.S. Centers for Medicare and Medicaid Services is expected to decide in November whether Medicare will pay for CT lung cancer screening exams for its beneficiaries. CT screening has been shown to reduce mortality for high-risk smokers of all ages, but an expert panel in April raised major questions about whether the benefits of the scans would outweigh the harms in the Medicare population 65 years and older.
One of the new JAMA editorials tries to strike a balance by proposing a formal system of shared decision-making between physicians and individuals eligible for screening. The system could include a sort of patient decision aid that summarizes evidence on CT screening.
The second editorial proffers the idea that the benefits of CT screening haven't yet been proved for older individuals, and it proposes a new clinical study like the landmark National Lung Screening Trial, but this time focusing on the Medicare-aged population.
How is the radiology community responding to the editorials? While some are cautiously receptive, others doubt the new proposals are realistic. Read more by clicking here, or visit our CT Community at ct.auntminnie.com.
The dismemberment of radiology PACS
PACS consultant Michael Gray is back with the second installment of his three-part series on the shifting landscape in PACS.
Part 2 of his PACS Paradigm Shift series focuses on what he calls the "dismemberment" of the radiology-oriented PACS model that served medical imaging so well as it moved from film-based to filmless operation.
In a process that began with the launch of the vendor-neutral archive (VNA), radiology has slowly lost control of digital image management, Mr. Gray believes. Instead, a world of enterprise-based imaging has developed, with VNAs at the center and universal viewers providing access to images for physicians throughout the enterprise.
But the evolving new model raises a number of issues that imaging facilities have to deal with, issues that Mr. Gray explores in detail. Learn more by clicking here, or visit our Imaging Informatics Community at informatics.auntminnie.com.
