CT scans are likely overused; my spouse has several chronic conditions and after receiving dozens a year for a while, we started asking if a CT was clinically indicated, or just precautionary. Mostly the response is "just in case". I wish EMRs did a better job of highlighting how many CTs someone's had recently for this sort of decision making.
There've also long been problems with kids getting unnecessarily high adult doses of radiation. My dad's a peds radiologist and was heavily involved in the founding of https://www.imagegently.org/.
My kid needed an abdominal ultrasound in the ER, but the ultrasonographer had gone home for the night. They did a CT instead, despite my concerns. CT missed the problem, which festered for several more years before being discovered during our next ER visit … on an ultrasound.
The "almost certainly" that you brush off is the entire point of the calculation. Is it 95% certain or 99.5% certain? The exact balance between benefit and risk in medical procedures is exactly how it is determined when to use them in the standard of care.
My first MRI about 30 years ago they did a precautionary CAT scan of my head because I had worked in machine shop (the place I worked had a machine shop and I used it for small personal projects), dunno if they do that anymore, but I was told ferrous bits in eyes had led to disastrous results for at least one patient.
Yeah, no. A doctor that I had a feeling wasn't paying too close attention to what I was saying ordered a pelvic/abdominal CT with and without contrast, ~30-40 mSv. Nothing turned up on the scans. When I went back he said "nothing's wrong" and, confused, I described my symptoms again. He just said "Oh! You need physical therapy."
Two weeks of physical therapy and I was fine.
At the time I was mad about the money, now I'm just thinking "what a dumb way to (maybe) get gut cancer."
I was young. I thought I was scheduled for an MRI like the one I had for my sinuses. I didn't even know what a was CT at the time.
On the other side of the coin, my always healthy dad did 6 weeks of physical therapy for hip joint pain that turned out to be cancer, which was immediately detected when they finally decided to perform a CT scan. He passed away almost exactly 1 year later at 46 years old.
Thanks, and I was trying to highlight the challenges of any situation like this. I do agree with the fundamental premise that we need to get better and deciding when to scan and coming up with non(or less) destructive techniques.
CT scans are likely overused; my spouse has several chronic conditions and after receiving dozens a year for a while, we started asking if a CT was clinically indicated, or just precautionary. Mostly the response is "just in case". I wish EMRs did a better job of highlighting how many CTs someone's had recently for this sort of decision making.
There've also long been problems with kids getting unnecessarily high adult doses of radiation. My dad's a peds radiologist and was heavily involved in the founding of https://www.imagegently.org/.