Given the recent discussion here and elsewhere on the role -- or lack thereof -- of technical innovation in producing health comes the results of a study in the latest Health Affairs documenting significantly expanded use of medical imaging techniques without solid evidence of improved health outcomes. Here is the Abstract:
The availability of computed tomography (CT) and magnetic resonance imaging (MRI) scanning has grown rapidly, but the value of increased availability is not clear. We document the relationship between CT and MRI availability and use, and we consider potentially important sources of benefits. We discuss key questions that need to be addressed if value is to be well understood. In an example we study, expanded imaging may be valuable because it provides quicker access to more precise diagnostic information, although evidence for improved health outcomes is limited. This may be a common situation; thus, a particularly important question is how non-health-outcome benefits of imaging can be quantified.
The full-text is available for download free of charge. In addition, this issue features a number of articles discussing different aspects of health policy and medical imaging, many of which seem promising at first glance.
In my view, the role of imaging techniques in constructing notions of health and illness cannot be understated. I am biased, as a significant portion of my dissertation on pain involves assessment of the power of the visible both in Western culture in general, and in the cultures of biomedicine and science in the U.S. in particular. Nevertheless, understanding the appeal of imaging techniques seems to require some understanding of the role of images of the inner body in U.S. society. For an excellent and timely exposition of this subject, see Kelly Joyce's recent monograph entitled "Magnetic Appeal: MRI and the Myth of Transparency."* There are a number of additional sources I can recommend for those interested.
*Sidebar: For a variety of reasons, I do not like the term "myth" as used to refer to a community's beliefs about health and illness. Still, Joyce's perspective is important and informative, in my view.
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